Standard Diagnostic Imaging Requisition Forms are now in effect.
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).
If you are interested in pursuing electronic referral, please contact the System Coordinated Access Team at eReferral@ehealthce.ca or call 519-885-0606 ext. 1040
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
- Canadian Association of Radiologists | Referral Guidelines
- Choosing Wisely Canada – a campaign to help physicians and patients engage in conversations about unnecessary tests, treatments and procedures.
Hours of Operation
- Weekdays: 8:00 a.m. to 5:00 p.m.
- Emergency only 24/7