Weill Cornell Imaging Prescription Uploading

If you are a patient who has been referred for imaging or a provider who has referred a patient for imaging, please fill out the information below to upload the prescription and to request scheduling the appointment online. Thank you for choosing Weill Cornell Imaging!

Are you the patient or provider?

Patient
Provider

Patient Information

First Name

Last Name

Date of Birth (MM/DD/YYYY)

Referring Provider Name