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Physician Referral Form

When you refer a trusted patient to Starling Diagnostics, you can be sure they will receive the highest quality radiology services from doctors who truly care.

Our team of board-certified radiologists consistently define excellence when it comes to diagnostic radiology. Whether your patient requires a routine procedure or a more complex form of testing, know that we have the expertise to help them.

For your convenience, please complete and submit the interactive physician referral form below. If you would like to discuss a particular patient before referring them to us, please do not hesitate to call us 
at (718) 319-1610.

Fill the Form

    First Name

    Second Name

    Phone

    Email

    Name 1

    Name 2

    Name 3

    Name 4

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