E-Referral Allied

E-Referral Allied Form
Referrer *

Medicare Guidleines for Allied

Patient Details

DD/MM/YYYY
Gender *
Booking Appointment
Allied health practitioners cannot refer more than one of the following spinal services on the same day.
Examination *
C Spine
T Spine
L Spine
Other
Hips
We are able to accept requests for other radiological imaging examinations, where the Radiologist determines that “the service is clinically relevant for the treatment of the patient’s condition”. Importantly though, these examinations may not attract a Medicare rebate for the patient.
Please include Modality such as Xray or Ultrasound
Examination *
Unlimited Referrals
No time restriction
Hips side
Allied health practitioners cannot refer more than one of the above spinal services on the same day.
Limited Referrals - only one of the following xrays can be performed per calendar year
Please include Modality such as Xray or Ultrasound
Examination *
Body part
Side
We are able to accept requests for other radiological imaging examinations, where the Radiologist determines that “the service is clinically relevant for the treatment of the patient’s condition”. Importantly though, these examinations may not attract a Medicare rebate for the patient.
Please include Modality such as Xray or Ultrasound

Clinical History

Referring Practitioner

(Used to login to InteleViewer or Inteleconnect)
Copies to another referrer?
*
Branch *
Please select a branch. Appointment might be at another branch. No CT at Goonellabah or Maclean

Branches

North Coast Radiology
Clarence Valley Imaging

North Coast Radiology

Phone: 1300 66 XRAY (1300 66 9729)
  • Ballina - 93 Tamar Street
  • Byron Bay - Byron Bay Fair, Shop 2/20 Bayshore Drive
  • Casino - 133-145 Centre St
  • Goonellabah - 799 Ballina Rd
  • Northern Womens Imaging - Suite 7, St Vincent’s Hospital
  • Nuclear Medicine - Suite 6, St Vincent’s Hospital
  • St Vincents Private Hospital - Suite 4

    • Clarence Valley Imaging

  • Grafton - 137 Fitzroy Street - 6604 2400

    • © 2022 North Coast Radiology Group. All rights reserved. Privacy Policy. Whistleblower Policy.
    Meta