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Become a referrer

We welcome referrals from AHPRA medical and allied health practitioners.

To become a referrer, please complete the form below and one of our Customer Relations Managers (CRMs) will be in touch.

If you are already a referrer and have changed locations, please update your details by clicking here

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Clinician name(Required)

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Medical practitioner - specialist

Medical practitioner - GP

Medical practitioner - public hospital medical officer

Allied health clinician

Dental practitioner

Other

Mobile number

Primary location (surgery or hospital name)(Required)

Primary location provider number (or AHPRA ID)(Required)

Primary location street address(Required)

Primary location suburb(Required)

Primary location postcode(Required)

Primary location phone number(Required)

Please provide additional clinic locations/provider numbers

Clinic location

Provider number

Please contact me about (select all options that apply)

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Perth Radiological Clinic respectfully acknowledge the Traditional Custodians of the Country throughout Western Australia and recognise their continuing connection to lands, waters, and communities. PRC pays respect to Aboriginal and Torres Strait Islander cultures, and to Elders both past and present and emerging.

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Official medical imaging provider for the Fremantle Football Club, Perth Glory, Perth Football Club, and West Perth Football Club.

Member of the Australian Diagnostic Imaging Association

Perth Radiological Clinic

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