Lakes Radiology: Online Appointment Request

Appointment Request

ONLINE BOOKING REQUEST

We strive to make your booking experience as simple and stress-free as possible.

If you’re unsure about any part of the process, don’t worry—our team is here to assist and ensure you get the test you need. The information below will guide you and answer some frequently asked questions to keep the process smooth and efficient.

Important: Submitting this request does not confirm an appointment. A member of our team will follow up shortly to discuss your request and schedule a time. If you’d like to speak with someone right away, please give us a call.

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 request, I understand that if I have flu-like symptoms on the day of my appointment, I will be required to reschedule.