* F5 to reopen menu ** check sites below for further details Brooke Radiology Locations Greig Associates Locations West Coast Medical Imaging Locations WCMI reference Valley Medical Imaging Locations MedRay Imaging North Shore Medical Imaging
Outpatient Radiology Patient Information: ▲ ▼ Appt: Date: Referring Doctor: ▲ ▼ Copy To: Billable To: MSP ICBC WCB Other: Exam: Clinical Information: ▲ ▼ Patient Instructions: ▲ ▼
Brooke: Metrotown #100 - 4980 Kingsway Burnaby Phone 604-434-1345 Fax 604-435-1309 UXMB M-F 8:00-5:00 Brooke: North Burnaby #20 - 4218 East Hastings St. Burnaby Phone 604-299-2666 Fax 604-299-5773 UX M-F 8:30-5:00 Greig: Victoria Dr 5732 Victoria Dr. Vancouver Phone 604-321-6774 Fax 604-321-6626 UX M-Th 7:15-9:00 pm; F-Sa 7:15-5:00 Greig: Oakridge #219 - 650 W. 41st Ave. Vancouver Phone 604-261-3177 Fax 604-264-4815 XB M-F 9:00-5:00; Sa 9:00-3:30 X-RAY 505: VGH/Fairmont #505 - 750 W. Broadway Vancouver Phone 604-879-4177 Fax 604-879-4147 UXM M-F 7:30-5:00; Sa 8:00-12:00 WCMI: VGH/Laurel Medical Ctr #106 - 888 W. 8th Ave Vancouver Phone 604-879-7726 Fax 604-879-7725 XH M-F 8:30-5:00 By appt ONLY. Call and book. WCMI: W Broadway/Arbutus #390 - 2184 W. Broadway Vancouver Phone 604-731-2200 Fax 604-736-9314 Temporarily CLOSED Jun2020 WCMI: St Paul’s/Burrard #270 - 1144 Burrard St. Vancouver Phone 604-689-8925 Fax 604-689-3364 X M-F 9:00-5:00 WCMI: Kerrisdale #6 - 5337 West Blvd. Vancouver Phone 604-325-3244 Fax 604-325-0136 U M-Sa 8:30-4:30 X M-F 10:00-2:00 WCMI: E Broadway/Commercial #430 - 1669 E. Broadway Vancouver Phone 604-873-1846 Fax 604-873-6318 UXM M-F 8:00-4:30 U only - Sa 9:00-2:00 NSMI: North Vancouver 139 West 16th St. North Vancouver Phone 604-987-9729 Fax 604-855-0109 UXM-MRI M-F 7:30-5:45 (T-Th to 8:15 pm) Sa 7:30-1:45 ** (website) #100 - 3001 Gordon Ave. Coquitlam Phone 604-941-7611 Fax 604-942-4612 UX-MRI M-F 8:00-4:30 Evenings and Sa closed
Subject:

Creative Commons License Generic Imaging Requisition, Burnaby version, updated to V5_Jun14_2020 by Dr. John Yap, is licensed under a GPL. Please consider supporting OSCAR BC.

TYPE OF PROCEDURES:

OBSTETRICS:
LMP: EDC:
First Trimester Dating OBS US
Antepartum bleeding OBS US
Detailed 18 week OBS US

MODALITY:
X-ray Ultrasound
Barium Enema ES&D

SIDE:
Left Right Bilateral

BODY PART:
Head Sinuses
Chest Abdomen Pelvis
C-spine T-spine L-spine
Shoulder Shoulder FOI
Humerus Elbow Forearm
Wrist Scaphoid Hand Finger
Hip Hip THA Femur
Knee Knee TKA Knee OA
Lower leg Ankle Foot
Ankle OA Foot OA

PATIENT INSTRUCTIONS:
Patient to book
X-ray:
UGI, esophagus, small bowel
Ba enema
Hysterosalpingogram
Ultrasound:
US Abdomen
US Abdomen and Pelvis
US Renal
US Pelvis or Obstetric
Mammogram:
Mammogram
BMD:
Bone Mineral Density

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U = Ultrasound
X = X-ray
M = Mammography
F = Fluoroscopy
B = BMD
H = Hysterosalpingogram