Referral Forms

Please contact our dedicated Radiology Services Liaisons to request referral pads.

Email: wcinyp-liaison@med.cornell.edu
Phone: (646) 962-5811

General Referral Script Form

Breast Imaging Script Form

Cardiac CT Script Form

PET CT and PET MR Script Form

CT Lung Screening Form

Weill Cornell Imaging at NewYork-Presbyterian

1305 York Avenue,
3rd Floor

New York, NY 10021

1283 York Avenue,
7th Floor

New York, NY 10065

520 East 70th Street,
Starr Pavilion, Ground Floor

New York, NY 10021

425 East 61st Street,
9th Floor

New York, NY 10065

2315 Broadway,
4th Floor

New York, NY 10024

53 Beekman Street,
Ground Floor

New York, NY 10038

416 East 55th Street
New York, NY 10022

28-25 Jackson Avenue,
2nd Floor

Long Island City, NY 11101