Referring Provider Instructions

To refer your pediatric patient to Radiology, please complete the following steps.

  1. Download and complete referral form

  2. Fax form: 832-825-3902

  3. Review and schedule
    After the referral is reviewed, the scheduler will call the patient to make an appointment.

If you have questions, please call this clinic directly at 832-826-5303.

Other Information

If you are a referring provider’s office needing assistance, please contact the Provider Connect team, M-F 8a-5p, excluding holidays:

  1. Phone: 832-TCH-CARE (832-824-2273)
  2. Toll-Free: 877-855-4857
  3. Email: