Download Physician Referral Form

A signed physician referral form is needed for all MRI, Ultrasound and Echocardiography Examinations.

We will accept any requisition form, however if you would like to obtain one for your doctor to sign, you can download one here.

Once the form has been filled out and signed by your doctor you can save it to your computer or device by scanning it or taking a picture. You can then send it to us by email or if you prefer by fax (604-575-5414).