CT Scan referral form

Healthcare professionals wishing to refer a patient for imaging may complete the download or online referral form below. This form will be submitted to our appointments coordinators who will then contact the patient directly to arrange an appointment.

Patients may arrange an appointment by telephone or email, although a referral will always be required to confirm a booking.

For further assistance, please call tel: 020 7833 2513 or email imaging@queensquare.com