Import to our PACS

This form to request image transfers to Apex.

For urgent after-hours transfers please submit this form and also call our RIS team on 1300 668 957

Request access to our PACS

Please complete the form below to request access to import in our PACS.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Patient Full Name*

Patient Date of Birth*

Radiology Provider*

Study Required - Body Region*

Study Date (if known)

Multiple Patient Request

Patient Name

Date of Birth

Study Required

Fax Number

Name*

Contact Number*

Email*

Hospital*

Department*

Date*