Referrals made simple

Online Referrals

Apex Radiology is now accepting diagnostic imaging requests via Telehealth.

Telehealth referrals further support our local community and our doctors, while GPs, Specialists and Allied Health Professionals begin to consult patients on a remote basis.

Apex Radiology offers the ability for doctors to send referrals safely, remotely and electronically.

Make a Referral

Please complete the form below to submit your referral.

Once submitted, this form is sent directly to our Bookings Centre, where your patient will be contacted to make their appointment.

PLEASE NOTE: This online form is for OUTPATIENT use only. In patient Hospital referrals should be submitted through your hospital’s electronic referral system and processed via the hospital’s established referral pathway.

"*" indicates required fields

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Appointment Details

Referral and/or request(s) to the doctors of Apex Radiology.

Referral Location*

Referral Date*

Patient Details

Name*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Medicare Number*

Phone Number*

Date of Birth

Patient Email Confirmation

Please tick if your patient would like a copy of this referral sent to them

Patient Email Address*

Please enter patient email if they would like a copy of referral.

Investigations Required*

Clinical Notes*

Referring Doctor Details

Name*

Address*

Street Address Suburb State Post Code

Provider Number*

Phone No.*

Doctors Email Notification

Please tick if you would like a copy of this referral sent to you

Email*

Send a copy of the patient report to:

Dr. First Name

Last Name

For patients who may require intravenous contrast (CT & MRI) and the patient is over 70 years old, or has suspected or known renal impairment please supply the serum levels within previous: 3 months for stable out-patient, 7 days for stable in-patient.