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Patients
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For Patients
Patients
COVID-19 (Patients)
Request an appointment
Payment
FAQs
Our Quality Principles
myRAD Patient App
Give Us Feedback
Privacy Policy
Terms and Conditions
Study Details - Patient Full Name
*
First
Last
Patient Date of Birth
*
DD
MM
YYYY
Study Required - Body Region
*
Study Date (if known)
DD
MM
YYYY
Multiple Patient Request
Patient Name
Date of Birth
Study Required
Consent
Report Required (fax only)
Fax Number
AUTHORISATION - By making this request I acknowledge that these images are required as part of the ongoing clincal management for this patient and will be managed in accordance with the Privacy Act 1988. Your name:
*
First
Last
Contact Number
*
Email
*
Date
DD
MM
YYYY
Images to be sent to
SKG
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