Initiate appointment booking for your Radiology Examination

Use this form to initiate the appointment booking process at any of our branches for all non-medically urgent appointments. Please do NOT use this form if your matter is medically urgent.

Your appointment is only confirmed after we have spoken with you directly and given you an exact time and date and all preparation advice for your examination.

Region *
Form completed by
Does patient have any Flu symptons? *
Any symptons such as fever, cough, sore throat or shortness of breath, or have been in a Covid Hot Spot please tick Yes.
Click here for for first available date and time. Untick if you want a specific date, day of week or preferred time frame as set below. We cannot guarantee a specific date but will do our best.
A copy of this request will be sent to this email address after you hit submit
Please include area code

Type of examination

No exam *
(Doctor or Practitioner asking you to have this examination)
Request Detail or Clinical History if not emailing referral form (email address to send referral to will be sent to you)

Please use one form for each separate referral form. Once we receive yourrequest, we will contact you to finalise the appointment booking and advise you of any special preparation requirements.

North Coast Radiology Group (NCRG) incorporates North Coast Radiology, Clarence Valley Imaging and Chatswood and Ryde Radiology. We accept all radiology referral forms.