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Patient Referral – Vascular Imaging

Download Patient Referral – Vascular Imaging Form (PDF - 186 Kb)

Referring doctors should be aware that Deep Vein Thrombosis (DVT) scans are Bulk Billed by our practice.

Please note: items marked * indicate mandatory fields.

Please enter phone number with area code included. No spaces please. eg. 0298765432
Please enter phone number with area code included. No spaces please. eg. 0298765432
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