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Referral Pads and Forms

Order Referral Pads

Complete this form to order referral pads. Referral pads will be delivered by your dedicated Referrer Liasion Officer (RLO) or sent via post.

Digital Referrals

We facilitate receiving referrals digitally via email, fax or direct upload.

During the COVID-19 pandemic, practitioners are able email their imaging requests to us, for both Telehealth and face-to-face patients. Once the imaging request has been completed, please email it through email it to Queensland X-Ray using one of the email addresses below.

Please include the patient’s preferred phone number and email address so we can contact them to make their appointment.


Gold Coast:





Fax the referral to 07 3343 7055

Alternatively you can send the referral directly to us by uploading here:


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Download information pack as a PDF