Order Referrals



Practices

 Pittwater Radiology Northside Medical Imaging Northwest Radiology Ultrascan Radiology Macquarie Street Radiology Central Coast Radiology National Capital Diagnostic Imaging South West Nuclear Medicine

Type of Pads

 General Referral Pad Bone Mineral Density Referral Chiropractor/Physiotherapist Referral Dental Referral Pad Vascular Referral Pad MRI - Ultrascan ONLY MRI - Referral Pad for GP's (North West Radiology ONLY)

Please note if the specific type of referral pad is not selected General Referral Pads will be sent.

Number of Pads Size

Details

The sections with * next to them are compulsory to submit the form.

* First Name
* Last Name
* Address Line 1
Address Line 2
* Suburb
* Postcode
* Phone
FAX
* Provider No.
* E-Mail

I-Med Network NSW: Leading diagnostic imaging provider in NSW, providing best in class service in radiology. Our network of clinics in Sydney and regional NSW provide a wide range of services including, x-ray, ultrasound, CT scans, MRI, Doppler, Fluoroscopy, dental x-ray and more.