Referrer Pads

We offer downloadable referral pads to streamline your practice’s imaging requests. Choose from the following formats:

• A4 Nuclear Medicine Imaging Request Forms
• A5 Nuclear Medicine Imaging Request Pads
  Doctors, download this form to request an examination for your patient. Also includes patient preparation for bone scans, myocardial perfusion scans, biliary scans, gastric emptying and renal scans (subject to specific medical advice).
  
  
• A4 PET / CT Referral Forms
• A5 PET / CT Referral Pads
  Doctors, download this form to request a PET/CT examination for your patient.