Request an appointment

To make an appointment with Catalyst Radiology you can phone us on (07)30362860 or fill in the form below.
Name*
First Name Last Name
Date of Birth*
Suburb
Contact No.*
Alternative Contact No.
Medicare Number
Concession Card Number
Email Address*
I give my permission to be contacted about matters relating to my appointment by phone or email. Please visit our Privacy Policy for more information about how we value and protect your privacy.
- Permission to contact
I give my permission to be contacted about matters relating to my appointment by phone or email. Please visit our Privacy Policy for more information about how we value and protect your privacy.
Referring Doctors Name
Service Required*
1st Preferred Date
DD slash MM slash YYYY

Weekdays only
Time
2nd Preferred Date
DD slash MM slash YYYY

Weekdays only
Time
Additional clinical information indicated on your referral
Referral Upload
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