Request a Bone Density Scan

If your doctor or provider has ordered a bone density scan, please use the form below to request your exam.

About Bone Density Scan (DEXA): A scan similar to an x-ray that quickly and accurately measures the density of bone. It is used primarily to detect osteopenia or osteoporosis, conditions in which the bone's mineral and density are low and the risk of fractures is increased.

Bone Density Scan (DEXA) Guidelines

Bone density scans require a physician's order
Women who are age 65 years or older without previous known fractures are eligible
Men or women age 65 or older who may have secondary causes of osteoporosis are eligible
Women younger than age 65 who may have additional risk factors for osteoporosis are eligible
Patient must NOT have had imaging with Barium or CT Oral Prep within 7 days of a bone density scan
Medicare covers this exam every two years
Bone Density Scans at Ferrell are provided Monday – Friday, 8 AM - 4PM

Bone Density Scan Request

First Name

Last Name

Phone

Date of Birth

Ordering Physician

Do you have a printed order from a physician?

Yes No

Is this your first Dexa Scan?

Yes No

Do you currently take a calcium supplement?

Yes No

Preferred Date

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