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Online Booking

All referral forms are accepted at MIA


Please note online bookings are subject to confirmation by our staff who will contact you within 24-hours of receiving the online request.

For general X-Ray booking enquiries you do not require an appointment and can contact the Clinic directly.

To find a Clinic near you and the Hours of Operation, please see our Locations page.
First Name*
Family Name*
Address*
Date of Birth*
Email Address*
Preferred method for our staff to contact you
Phone Email
Phone Number*
Other Contact Phone Number
Examination Required*
Preferred Suburb*
Select Clinic*
Referring Doctor
Your Preferred Time
Your Preferred Date*
Open the calendar popup.
Any relevant medical information we should know?
Upload Referral
JPG or GIF formats only
Maximum file size:2Mb
 
* To assist Clinical Staff, you have the option to Upload your Referral prior to confirming your appointment.
 
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* Required Field


                                
 
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