A signed requisition from a Healthcare Practitioner is required to book any diagnostic imaging exam.
PLEASE NOTE:
Please be sure your requisition is fully completed with your NAME, HEALTH CARD NUMBER, DATE OF BIRTH and a VALID PHONE NUMBER; these fields are REQUIRED to be filled out on the requisition photo in addition to this online form.
Kindly ensure a clear image of the entire requisition is uploaded so we can process your request without delay.
If any patient information is missing, the document is unclear, or only a partial image of the requisition is provided, an appointment will not be scheduled.