Stationery

Epworth Medical Imaging customises referral request stationery in the following formats that adhere to the Medicare Benefits Schedule guidelines:

A4 printer paper

Customised A4 printer paper allows you to print laser requests directly from your practice management system. For this option to work effectively, your practice management software must have its printer settings calibrated. For guidance to calibrate your printer, please click on the name of your practice management system below.

• Best Practice
• Genie
• ZEDMED
• Medical Director
• Clinic to Cloud

Downloads

• A4 GP MRI Radiology request form blank (PDF, 114 KB)
• A4 Radiology request form (PDF, 149 KB)
• A4 Radiology request form blank (PDF, 79 KB)
• A4 Radiology request form editable (PDF, 75 KB)
• Interventional Radiology & Pathology request form editable (PDF, 869 KB)
• PET/CT request form editable (PDF, 220 KB)
• PSMA request form editable (PDF 198 KB)

Handwritten request pads

Handwritten request pads have been developed for physicians that do not use a computer-based practice management system or prefer to handwrite requests. These request pads have fields for referrer details, required examination, clinical notes and delivery method. They can be used for any examination.

Personalised handwritten request pads

Handwritten request pads have been developed for physicians that do not use a computer-based practice management system or prefer to handwrite requests. Epworth Medical Imaging can customise requests for any referrer. Personalised request pads include a pre-printed referrer name, address, phone, fax and provider number.

Request pad orders

To order new referral stationery, please email kdamon@emi.net.au . If you are ordering personalised request pads, please ensure the correct details are entered to avoid delays including address, phone, fax, and provider number.

Request stationery

For stationery request please contact EMI Business Development Manager:

Matt Fennell
Email: MFennell@emi.net.au
Mobile: 0437 421 645