Imaging
Personal
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Imaging Online Details
Preferred Consultation Time *

If submitted after 18:00, your request will be processed the next day at first available

Type of Imaging *
Body area to be Imaged *
Reason for Imaging *
Are you taking medications? *
Upload Supporting Documents (Optional)

Upload doctor referral, previous imaging reports, or medical records. (Max 5MB)

Drag & drop files here or click to select files

I acknowledge that: *
  1. I have read and agree to the Terms and Conditions.
  2. This is not a medical emergency - for emergencies, call 000.
  3. Telehealth has limitations compared to in-person care and may not be appropriate for all conditions.
  4. I will see a doctor face to face if my condition doesn't improve.
  5. All information I have provided is true, accurate and complete to the best of my knowledge.
Personal Details
Payment Information
Secured by Tyro
Step 3 of 3
tyro
Payment Gateway
Imaging Request Fee $0001.00
Total to Pay $0001.00 AUD