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Nuclear Medicine Requisition Form

Woodstock Hospital conducts bone scans, thyroid scans and lung scans using nuclear medicine. Your physician’s office will make the appointment for you. Please bring a list of your current medications, your Health Card and the following requisition form, filled out, to your appointment.

To download:

Scroll to the bottom of the document and click on the download button on the left hand side.

but you are required to bring this requisition form with you. Click on the link below to download this form, print it and fill it in, before your appointment.


PDF
nameNM Requisition - may 2016.pdf

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