Upload and send Referral

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.

Our staff will call the patient to create an appointment using the phone number in this form. Please select the preferred branch for examination.


Do you have any Flu symptons?
If you have any symptons such as fever, cough, sore throat or shortness of breath, or have been in a Covid Hot Spot please tick Yes.
Day of the Week

Maximum file size: 20.48MB

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