This questionnaire is to schedule a bone density/DEXA exam performed at our Montgomery Street location in San Francisco, California. The address is 1725 Montgomery Street, 2nd Floor, Suite 250.
Do you have a referral from your provider?
A referral is a physician’s order. If your provider thinks a bone density/DXA exam is necessary, he or she will provide a paper order requesting the exam. If your provider is within the UCSF system, he or she will generate an electronic order.
We will need a referral from your provider to schedule you for a bone density/DEXA exam. At this time, we are unable to complete this request.
Do you want help getting a referral?
Please contact your provider for a screening mammography referral. You are welcome to fax or scan the referral and send it to us at (415) 986-2213 or UCSFMontgomery@ucsf.edu.
Once you have done this, please return to this form, or give us a call at (415) 502-1330.