Universal Medical Imaging
Examination Request
Ultrasound Pregnancy
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Signature:
8-10 wks for dates 1st trimester Screening
(FTS blood test)
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12-13 wks : Nuchal Translucency
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20 wks : Foetal Morphology
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3rd Trimester : Foetal Wellbeing and Placenta
LMP…………………….
…………………………………………………………
EDD ……………………
Date:
( Tick as required )
UMI Kingston
1/110 Giles Street
(Cnr Printers Way)
Kingston Foreshore
ACT 2604
enquiry@umic.com.au
 General X-Ray
 CT Scan
UMI Calvary MRI
Level 2
Xavier Building
(Main Entrance)
Calvary Hospital
mri@umic.com.au
Ph. (02) 6126 5000
Fax.(02) 6239 4242
www.umic.com.au
 Ultrasound
 MRI
 BMD
 Guided Procedures
 Imaging Consultations- Breast, Spine, MRI
 X-Ray
Prof Graham Buirski
Dr Ann Harvey
Dr Jeremy Price
Dr Tarun Jain
UMI Kingston
1/110 Giles Street
(Cnr Printers Way)
Kingston Foreshore
ACT 2604
enquiry@umic.com.au
Phone: (02) 6126 5000
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General X-Ray
CT Scan
U/S
DEXA
Mammography
Map data ©2012 Google, Whereis(R), Sensis Pty
Ltd
UMI Calvary MRI
Level 2
Xavier Building
(Main Entrance)
Calvary Hospital
BRUCE
mri@umic.com.au
Phone: (02) 6126 5050
 MRI
Universal Medical Imaging
Ph: 02 6126 5000
Fax;02 6239 4242