Referrals

​​​Hospital Referrals

• Electronic order entry (e-referral)

• Nuclear Medicine Requisition form QF00287. CDHB staff can view this form on the Intranet under Forms - Service /Department - Nuclear Medicine. http://cdhbintranet/corporate/cdhbpoliciesanddocumentation/CDHB%20Forms/Nuclear%20Medicine%20Request%20Form.pdf  

• Deliver or fax the form (ext. 80869) to the Nuclear Medicine Department.

 Private Specialist Referrals

• Nuclear Medicine Requisition form QF00287. 

• Post or fax (03 3640 869) the form to the Nuclear Medicine Department.

GP Referrals

• Nuclear Medicine Request Form - available on the CDHB HealthPathways website http://cdhb.healthpathways.org.nz/referral/Nuclear-Medicine-Request-Form.pdf. Post or fax the request to the Nuclear Medicine Department or send via GP Referrals.

• ERMS referral. Healthpathways - Investigations - Nuclear Medicine -            Request. Select: Bone Isotope Scan, Radionuclide Thyroid Scan or Nuclear Medicine Referral for other scan types. 

• For clinical criteria, refer to Bone Pain Pathway or Thyroid Pathway.

• ACC funded Bone Scans must be referred by a Specialist. ​

Referral Guidelines

Clerical

• Full name of patient ie. legal name including all middle names with correct spelling

• Date of birth and NHI number

• Mailing address including postcode

• Contact telephone numbers (include cell for txt reminder).

• Name of Referrer and Practice

• Service Requested

• ACC number if applicable, include date and details of accident

Clinical

• Provisional diagnosis and /or presenting problem

• Severity and duration

• Current medications/ known allergies

• Relevant patient history

• WEIGHT

• Any disabilities, mobility or cognitive problems, special needs eg. interpreter, hoist etc.

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Availability of Imaging Procedures

• For URGENT scans during working hours (0800 - 1630), phone the Scanning room (03 3640 867, ext. 80867) after faxing or sending an electronic referral. Urgent requests are performed as soon as possible.

• All efforts are made to scan patients within the requested time frames indicated on the referrals.

• Routine appointments are generally booked and sent out within a week.

• Some types of scans are grouped together and others are only available on certain days.

• Some specialised scans are not routinely available, contact Nuclear Medicine for advice before ordering.