Request an Appointment

To make an appointment, contact our Booking Centre on

1300 197 297

or complete the form below.

Request an appointment

Once we receive your appointment request, one of our team here at South Coast Radiology will call to confirm the date and time of your appointment, along with confirmation of your personal details.

Name*
First Name Last Name
Date of Birth*
Suburb
Contact No.*
Alternative Contact No.
Medicare Number
Concession Card Number
Email Address*
I give my permission to be contacted about matters relating to my appointment by phone or email. Please visit our Privacy Policy for more information about how we value and protect your privacy.
- Permission to contact
I give my permission to be contacted about matters relating to my appointment by phone or email. Please visit our Privacy Policy for more information about how we value and protect your privacy.
Referring Doctors Name
Service Required*
Preferred Date
DD slash MM slash YYYY

Weekdays only
Preferred Location
Additional clinical information indicated on your referral
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Request an Appointment

To make an appointment, contact our Booking Centre on

1300 197 297

or complete the form below.

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