Information for physicians referring patients for a PET scan
Thank you for referring your patient to the WA PET/Cyclotron Service. If you would like to discuss the referral with a PET consultant please telephone 08 9346 2656.
Referral forms may be obtained from the PET Service by telephoning 08 9346 2656, or alternatively, you may download forms for oncology, neurology or myocardial viability referrals.
Please note that only specialists and consultants may refer patients for PET scans, and the referral must be signed by them.
Please help us to provide an efficient service by noting the following when completing the referral form:
Ensure that the patient’s name, date of birth and contact telephone numbers appear legibly.
We are required to provide to the Commonwealth information regarding staging and management plans (oncology referrals), and clinical information (neurology and myocardial viability referrals) for all PET scan patients. Should your referral form be incomplete in these areas we will be required to return it to you for completion.
If you have any questions regarding the completion of the form our Data Manager would be happy to assist you, on 61 8 9346 4709.
Once completed, the form may be mailed to us at:
The WA PET/Cyclotron Service
Level 1, G Block
Sir Charles Gairdner Hospital
Hospital Avenue
Nedlands WA 6009
Or faxed to 61 8 9346 3610.
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