The Diagnostic Imaging Integrated Program Council, in partnership with the System Coordinated Access Program (SCA) have developed standardized regional diagnostic imaging outpatient requisitions. This means that all hospitals within Waterloo Wellington Region are now accepting the same forms for outpatient DI requisitions (i.e. for MRI, CT, etc.).
The standardized regional forms can be sent by fax, electronically (i.e. EMR custom form) or by an electronic referral solution (eReferral).
Click here to access OCEAN E-Referral with your credentials and search “St. Mary’s General Hospital.”
To add electronic referral to your practice, please click the link here or email eReferral@ehealthce.ca.
Access the Forms Here
Click here to access the form for X-ray
Click here to access the form for Ultrasound
Click here to access the form for Nuclear Medicine
Click here to access the form for CT
Click here to access the form for Bone Mineral Density
Nuclear Medicine
Patient privacy is important to us. In compliance with provincial legislation, St. Mary’s is committed to protecting patients’ personal health information. As part of the care plan, we may need to contact the patients by telephone. Please convey to your patients that they may receive a phone call or voice mail from Nuclear Medicine relating to their appointment.
- Physician Information – Nuclear Medicine
- Myocardial Perfusion Scan – Physician Referral Form
- Myocardial Perfusion Scan – Patient Instructions
(print landscape, double sided, flip on short edge or booklet) - For bone mineral densitometry bookings call 519-749-6990
Hours of Operation
- Weekdays: 7:00 a.m. to 5:30 p.m.
- Weekends and Statutory Holidays: 8:30 a.m. to 5:00 p.m.
On-Call Coverage
Contact Swtichboard: (519) 744-3311
Diagnostic Imaging
Click here for referral guidelines from the Canadian Association of Radiologists
Hours of Operation
- Weekdays: 8:00 a.m. to 5:00 p.m.
- Emergency only 24/7