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Order a Diagnostic Test for Radiology

 Radiology Requisition

Radiology Requisition

If the patient will require anesthesia for the exam, the patient will need a current History and Physical within 30 days of the scheduled appointment.

*Please note: An insurance prior authorization status and/or number is required on all MRI, CT Nuclear Medicine, IVR's and PET Scans.


Radiology Requisition Process


Step 1
Complete Form
Step 2
Review and Schedule

Complete the Radiology Requisition.

For best results, please use Google Chrome.

The Children’s Mercy Contact Center will call the patient within 2 business days to schedule an appointment.

Scheduled and requested appointment status can be found on the Wednesday referral reports.


Children's Mercy Adele Hall Campus

Radiologists are available on-call 24 hours a day, 7 days a week. Radiologists are available on-site 8 a.m. to 5 p.m., Monday through Friday, and 8:30-11 a.m. Saturday, Sunday and holidays.

Radiology Department
(816) 234-3270

(816) 234-3272
Monday through Friday 8 a.m. to 5 p.m.

Children's Mercy Hospital Kansas

Radiologists are available on-site 8 a.m. to 5 p.m., and by phone noon-5 p.m. Monday through Friday.

On-site radiologists
(913) 696-8194

Radiologists by phone
(816) 234-3270

Plain film
Available 24 hours a day, 7 days a week

Children's Mercy East Imaging Center

All radiology services available 8 a.m. to 10 p.m., Monday through Friday. Outpatient radiology and lab services are available noon-10 p.m., Saturday and Sunday.