Radiology Victoria customises referral request stationery in the following formats that adhere to the Medicare Benefits Schedule guidelines:
A4 printer paper
Customised A4 printer paper allows you to print laser requests directly from your practice management system.
A4 Radiology Request Form Download
Handwritten Request Pads
Handwritten request pads have been developed for physicians that do not use a computer-based practice management system or prefer to handwrite requests. These request pads have fields for referrer details, required examination, clinical notes and delivery method. They can be used for any examination.
Personalised handwritten Request Pads
Handwritten request pads have been developed for physicians that do not use a computer-based practice management system or prefer to handwrite requests. Radiology Victoria can customise requests for any referrer. Personalised request pads include a pre-printed referrer name, address, phone, fax and provider number.
Request Referral Pads
To order new referral stationery, please click the link below to fill in our order form. If you are ordering personalised request pads, please ensure the correct details are entered to avoid delays including address, phone, fax, and provider number.