Schedule an Appointment

Imaging Services

Physician Offices: please refer your patients to us using the forms below, and fax directly to our Radiology Central Access Team for follow up.

They are able to discuss the details of our screening options with you should you have any questions.

• Fill out the MR Prostate Radiology Requisition Form.
• Fill out the MRI Safety Screening Questionnaire.
• Fax both forms to (310) 794-9035 "Attn: UCLA Prostate Imaging Program".

MR Prostate Radiology
Requisition Form

MRI Safety Screening
Questionnaire

Targeted In-bore MRI-Guided Biopsy

Physician Offices: please refer your patients for the prostate biopsy using the form below, and fax directly to our Radiology Central Access Team for follow up.

They are able to discuss the details of our screening options with you should you have any questions.

• Fill out the MR Prostate Radiology Requisition Form.
• Fax both forms to (310) 794-9035 "Attn: UCLA Prostate Imaging Program".

MR Prostate Radiology
Requisition Form

Treatment Services (PAE, TULSA)

Please call the Interventional Radiology Clinic Scheduling Team at (310) 481-7545 to schedule your consultation with a Interventional Radiologist.

You can also submit a request form here: Request an Office Visit >