Illawarra Radiology Group has developed a number of referral stationery formats that our referrers can access to assist in completing requests for various examinations, in line with the Medicare Benefits Schedule guidelines.

A4 Laser Requests

A4 Laser requests are for use in laser and bubble jet printers. These allow the physician to print requests directly from their practice management system. For A4 laser requests to work effectively, your practice management software must have its printer settings calibrated. For more information about how to calibrate your printer click on the name of your practice management system below.

Handwritten Requests

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

Personalised Requests

IRG can provide personalised requests to any of its referrers. These are a handwritten style request with the referrer’s name, address, phone, fax and provider number pre-printed.

Download a digital copy of our requests below:
A4 Laser Request
Handwritten Request
A4 Editable Request
Handwritten Editable Request
Telehealth A4 Editable Referral

Request Pad Orders

To order new referral stationery please fill out the online form below.  Your request pads will be delivered within one week of placing the order. If you are ordering personalised request pads please ensure your correct details are entered in order to avoid delays.

Request Stationery