Order Referral Pads

For more referral pads, please call (310) 423-5678. We have pads for the following areas:

You may also click on the links above for downloadable and printable prescription forms.

Fax Prescription Forms

Please fax the completed forms to scheduling at (310) 423-0137.

Online Request to Schedule

You can also use our Online Request to Schedule Form.


The S. Mark Taper Foundation Imaging Center provides a full range of advanced imaging, both radiology and cardiology, as well as interventional radiology and interventional tumor (oncology) treatments to the greater Los Angeles area, including Beverly Hills, Encino, Mid-Cities, Sherman Oaks, Silver Lake, Studio City, Toluca Lake, and West Hollywood.  

print button
WP3