Optimal gynecological sonography requires interaction between physician and patient since pain localization and organ mobility cannot be assessed on static images. New Mexico Sonographics (NMS) are a group of sonographers who serve remote New Mexico medical facilities reducing this interaction. Images are uploaded from GE Voluson Expert equipment into a server as they are performed to be reviewed elsewhere. For two years the author has interpreted NMS gynecological teleradiology studies. The sonographers have been trained to report on pain severity by anatomic location and videotape brief cine runs if organ mobility is in question. Color Doppler images and 3D views of the uterus and of masses are obtained on all patients however the computer setup does not allow the 3D views to be manipulated by the interpreter. Patient requisitions normally have sparse details about the patient's background. A detailed patient encounter form filled in before the exam has improved sonographic and interpretation quality. Many of these rural New Mexican patients are Spanish speaking and others have low literacy rates; only 60% of the initial forms provided complete information. The encounter form covers menstrual history, symptoms, medications, contraceptive technique, surgical history, sexual history and sexual infections and has segments on abnormal bleeding, infertility and pelvic pain. Of particular value has been information about past surgery, contraception approach, STD history and pain location however questions about menopausal symptoms were misleading since many young patients reported hot flashes and vaginal dryness. Although initially unpopular, the sonographers operating without direct medical supervision now find the forms helpful. A steady improvement in report and image quality has occurred over the course of 1100 gynecological ultrasound studies.