Oshawa Imaging Centre

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REQUEST FOR CONSULTATION. Oshawa Imaging Centre Courtice Imaging Oshawa Clinic Courtice Health Centre Taunton Health Centre 117 King St. E., Oshawa , On. L1H 1B9 1450 Highway #2, Courtice, On L1C 3C3 1290 Keith Ross Court, Oshawa L1H 7K4. Ph. 905 721-3588 fax905 721-3560 Ph. 905 721-4932 Fax 905 721-3524 Ph. 905 721-7702 Fax 905 721-7704. PLEASE BRING HEALTH CARD AND THIS REQUISITION. DIAGNOSTIC Imaging . NAME:___________________________________ _________________________________. ADDRESS: ________________________________________ _ OHIP # PATIENT LABEL. ________________________________________ ____. HERE. ________M _______D _________Y PHONE #: ( ) ____________________. WSIB:___________________________________ _________________________. APPOINTMENT: DATE: ______________________ TIME: ______________.

REQUEST FOR CONSULTATION Oshawa Imaging Centre Courtice Imaging Oshawa Clinic Courtice Health Centre Taunton Health Centre 117 King St. E., Oshawa, On. L1H 1B9 1450 Highway #2, Courtice, On L1C 3C3 1290 Keith Ross Court, Oshawa L1H 7K4

  Center, Imaging, Oshawa imaging centre, Oshawa