Outpatient Imaging Request Form

Outpatient Imaging Request Form

This form is for you to request a CT scan, MRI study, abdominal ultrasound or echocardiogram as an outpatient service. Please note that you will remain the case-owner and the patient will not see a specialist. Therefore, please ensure you select the correct modality. If you are in doubt, please call or email our team to discuss the case: info@vsos.com.au or (02) 8376 8767.

Please fill out the below information about your client/patient and upload all relevant history and blood work so that we can process your request as quickly as possible.

Thank you.

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