FMIG accepts Telehealth imaging requests by email or fax.
- Download the editable pdf here - FMIG Request Form.
- Attach completed pdf Request Form and email it to: email@example.com
- Type the Patient NAME in the subject line of the email, for identification.
- FMIG will contact the patient to confirm an appointment time.
- The FMIG referral (RTF) for BEST PRACTICE integration is also available for upload to your medical practice software system (eg Best Practice, ZedMed, Medical Director); or email your request to firstname.lastname@example.org and the template file will be provided.
- Standard referral forms (pdf file) can be downloaded here.