Telehealth Referrals
Referrers who conduct telehealth consultations can submit referrals on behalf patients through the below process.
What is needed?
To complete your Lumus Imaging Telehealth request, please download the form below.
1
When filling out a request, the following information is required:
- Patient information including date of birth and contact phone number
- Examination requested and clinical history
- Name of person making the request including
- Provider number and practice details date of request
Please ensure you make a record in the patient's file that the referral has been sent.