Radiology Referral Form

Thank you for considering a referral to our hospital. We value your trust in our expertise and commitment to providing the highest level of care to your patients.

To streamline the referral process, we have made it easy for you to refer your patients to our Radiology services. You can download the referral form by clicking on the link provided below:

Instructions for Referral:

1. Click on the provided link to download the referral form.
2. Once downloaded, please fill out the referral form with the patient’s information.
3. Save the completed form to your computer for your records.
4. Attach the form together with medical records to an email and send it to refer@grmc.gu for processing.

1. Feel free to add any additional comments or information that you believe will be helpful for our specialty team.

   Once we receive the completed referral form, our scheduling team will contact the patient to arrange an appointment with the appropriate specialist. We will keep you informed throughout the referral process and provide updates on the patient’s progress. You may also access your patient’s records through GRMC Clinician Portal.

   Thank you for choosing our hospital for your specialty referral needs. We are dedicated to delivering outstanding care to your patients and working in collaboration with you to ensure the best possible outcomes.

   If you have any questions or require assistance with the referral process, please do not hesitate to contact our referral coordinator