e-Referrals

Sending e-Referrals with Western Radiology is simple.

Online e-Referral Form

Referrals

Which referral forms are valid?

Remember, you can send us a copy of a referral generated by your computer as part of your normal referring process (just fax or email a copy over).
Email to: bookings@westernradiology.com.au
Fax to: 9200 2778

You can download our editable A5 referral form or A4 referral form.
If you have your own template and are referring on plain paper, that’s fine too. All referrals are accepted at Western Radiology.

Don’t have access to any of these? Refer via our online e-Referral form

Urgent Appointments

Is your referral for something urgent? Do not refer here, please call 9200 2777 so we can expedite your patient’s care.

Cardiologists

Download your editable A5 Cardiac referral form or editable A5 Cardiac MRI referral form.

Please complete the following form to submit your e-Referral:

Referrer Details

Patient Details

Service Locations

Canning Vale

1/410 Ranford Rd, Canning Vale WA 6155, Australia

(08) 9200 2777

Clarkson

10/61 Key Largo Drive, Clarkson WA 6030, Australia

(08) 9200 2777

Cockburn Central

2/810 North Lake Road, Cockburn Central WA 6164, Australia

(08) 9200 2777

Madeley

1/210 Wanneroo Rd, Madeley WA 6065, Australia

(08) 9200 2777

Morley

133 Russell St, Morley WA 6062, Australia

(08) 9200 2777