Radiology Referral

Fill in the form below to request a radiology referral.

Only reasonable and common radiological investigations can be ordered through Ezimed eg. MRIs will not be offered unless there is a good reason provided.
Other tests such as mammograms may require the patient to undergo counselling before the test and will therefore not be offered.
You may not be able to have CT scans with contrast if your kidney function is not known or available. Likewise if you have an allergy to contrast or iodine, you may not be able to have CT scans or nuclear scans.

Standard orders will be completed within 24 hours (Monday to Friday)

Express orders can only be completed between 9am to 5pm Monday to Friday AEST.

Standard orders will be completed within 24 hours. (Monday to Friday).

Express orders can only be completed between 9am to 5pm Monday to Friday AEST.

Once you've had your test done, let us know so we can follow-up your results. If you do not wish for Ezimed to follow-up your results, please let us know in the "Comments" box.

Order Type

Normal (Referral, results sent to GP and you), $34.95

Express (Referral in 2 hours, referral will be emailed to you, results to you and GP), $44.95

Choose your order type

Radiology Test Type *

Choose your test / scan type and provide details about the exact test you'd like a referral for and why you require the test.

Body Part to be Scanned (X-ray) *

Location of X-ray scan *

Use this only if the location you need scanned is not in the above list

Which Side to be Scanned *

Some scans will be for a specific side, your right hand for example

Body Part to be Scanned (CT) *

Which Side to be Scanned *

Some scans will be for a specific side, your right knee for example

Body Part to be Scanned (Ultrasound) *

Which Side to be Scanned *

Some scans will be for a specific side, your right shoulder for example

Please explain why you need this test? *

Is this test for yourself? *

If you are ordering this test for a child / dependant you need to let us know.

The full name of the person the test is for

What major medical problems do you have?

Do you have any allergies?

Preferred Radiology Provider *

What is the most convenient radiology centre for you to get to? If you don't know your closest radiology lab you can search google to find one near you.

Name if other *

Full Lab address *

Choose your delivery type *

How would you like us to send you your referral (and results if applicable)? Please note: Your information may not be secure if sent by email, as email is insecure)

Your fax number if chosen *