Canberra Diagnostic Imaging - storage.googleapis.com · A/Prof Barry Elison FRACP Dr Niri Ganeshan...
Transcript of Canberra Diagnostic Imaging - storage.googleapis.com · A/Prof Barry Elison FRACP Dr Niri Ganeshan...
Healthcare Imaging Services Pty Ltd ABN: 65 080 595 937 HISNREF???? - 12/15
Your doctor has recommended you use Canberra Diagnostic Imaging. This request is valid at other Radiology providers.
Canberra Diagnostic ImagingNational Capital Private HospitalLevel 1, Corner Gilmore Crescent & Hospital Road, Garran ACT 2605Ph 02 6195 8900 Fax: 02 6195 8999
Dr Karen Falk FRANZCRA/Prof Barry Elison FRACPDr Niri Ganeshan FRANZCR
Canberra Diagnostic ImagingNational Capital Private HospitalLevel 1, Corner Gilmore Crescent & Hospital Road, Garran ACT 2605Ph 02 6195 8900 Fax: 02 6195 8999
Patient Privacy Declaration We are bound by the Privacy Act 1988 (Cth) and other state and territory laws that regulate personal information and health information. Details on what information we collect, use, store and disclose and your rights to access and update that information is contained in the Healthcare Imaging Services privacy policy. I hereby consent to the collecting, using, storing and disclosing of my personal information and health information in accordance with the Privacy Policy.
Signature:_____________________________________________ Date: ___________________
Patient appointment Payment at time of service is required
Centre
Date / / Time :
PLEASE BRING ANY RELEVANT PREVIOUS X-RAYS FOR COMPARISON
Patient preparation instructions• Ultrasound Upper Abdomen Nothing to eat or drink for 8 hours prior to the test.
Specific instructions will be given at time of makingappointment for the following examinations:• CT Scanning • Women’s Imaging• DSA • MRI• Interventional Procedures • Nuclear Medicine• Ultrasound
MRI 3T General X-Ray Women’s Imaging
Low Dose CT 320 Ultrasound Nuclear Medicine
Cardiac Imaging Interventional Procedures Sports Imaging
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National Capital
Private Hospital
SouthernCar Park
TO WODEN
TO FYSHWICKTO GARRAN SHOPS
TO CITY
Canberra Diagnostic
Imaging
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Yamba DriveCar ParkP
Centenary Hospitalfor Women and Children
EmergencyDepartment
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