To request a Radiology appointment at Swan Hill District Health, please fill in the below form and a member of our friendly reception team will be in touch to arrange an appointment.

Radiology Appointment Booking Request Form

Name *

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Last

Phone *

Email *

Referral Document Upload *

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Scan Type *CT ScanX-RayUltrasoundMammographyFluoroscopyInterventional Procedures (including injections)

Note section

Previous reports ( If applicable)

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