Brighton Radiology has separate questions for patients and health care practitioners who are referring a patient to Brighton Radiology. At the beginning of the below form, please indicate whether you are a patient or a practitioner, so that the appropriate questions can be shown.

IN ADDITION: We only require patients to complete the patient questionnaire if they are having an MRI. If you're unsure what imaging you require, please leave the form and we'll complete it, if necessary, when you come in for your appointment.

If you have come to this page after completing an appointment request form, please phone 0417 160 912 now to confirm your appointment day and time.