Kokstad Private Hospital
039 797 8340
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Refer a Patient for a CT Scan

Please complete the form below electronically
or
Download and fax/email the completed form to 039 727 4598

Download CT Scan Request Form
Please note we need approximately 24hrs to obtain authorisation for a non emergency CT scan. Once authorisation is obtained we will contact you and your patient with a date and time of CT Scan. 
Picture

    CT Scan Request Form



    This is only necessary if you are requesting a contrasted CT Scan - please put "N" if not requesting contrast
    This is only necessary if you are requesting a contrasted CT Scan - please put "N" if not requesting contrast
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Contact Us
51 Barker Street, Kokstad, 4700
Tel: 039 797 8340
Fax: 039 727 4598
info@kokstadprivatehospital.co.za