Radiology Queensland Appointment Request

Appointment Request

REQUEST AN APPOINTMENT

At our patient-centred practice, we’re committed to making the appointment request process as easy and stress-free as possible.

Please note: This form is an appointment request only and does not guarantee a confirmed appointment time. Our Booking Team will contact you to discuss your preferred appointment, confirm the details, and provide any preparation instructions if required. If you’d prefer to speak with someone directly, please call us on (07) 5413 5000.

First Name

Last Name

Date of Birth (DD/MM/YYYY)

Gender

Is your appointment related to a workplace injury?

Yes No

Service

Date - first preference (DD/MM/YYYY)

Time - first preference

Date - second preference (DD/MM/YYYY)

Time - second preference

Phone number

Email address

Copy of referral #1 (Scan or take a photo of your referral and upload it here)

Copy of referral #2 (Scan or take a photo of your referral and upload it here)

Other information

By submitting this form, I acknowledge that if I experience flu-like symptoms on the day of my appointment, I will need to reschedule.

My Health Record Notice: From 1 July 2026, pathology and diagnostic imaging providers are generally required to upload results to My Health Record by default. Please note: Our practice has been granted an extension to implement this requirement. During this time, your diagnostic imaging reports and results will not be uploaded to My Health Record. If you have any questions, please speak with a member of our team.