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Patient Forms

Download and print the forms you need for your visit. A physician requisition is required for all diagnostic imaging.

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Forms & Requisitions

Download, print, and bring the relevant form to your appointment. Please remember to bring your valid health card.

Ultrasound Requisition

The standard requisition for ultrasound examinations, completed with your physician.

Bring this form to your appointment

Download PDF

Need help with a form?

If you are unsure which form you need or how to prepare, our team is happy to help.

Call +1 (289) 481-0263
A requisition from your physician or healthcare provider is required for all diagnostic imaging. If you do not yet have a requisition, please speak with your physician.
Patient resources

Read Before Your Visit

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Have Your Form Ready?

Once you have your requisition, call us or request an appointment online and we will take care of the rest.

Book an Appointment Call +1 (289) 481-0263

This website is for general information only and does not replace medical advice. Please speak with your physician or healthcare provider regarding your medical concerns. Imaging results are interpreted by qualified professionals and sent to your referring physician.