Specialty request forms A number of specialty appointment request forms for the Nashua area are available for download. If you have questions, please call the department directly. Outpatient Referral Form (PDF) CT, MRI and MRA Order/Pre-Authorization (PDF) Gastroenterology Appointment Request (PDF) General Surgery Appointment Request (PDF) Pediatric referral forms Prenatal Diagnosis & Maternal Fetal Medicine Referral Form (PDF) Prenatal Screening Lab Requisition (PDF)