Requisition Form

For Doctors / Patients

We Accept All Requisition Forms

Toronto Queensway Ultrasound and X-Ray accepts all medical requisition forms from your doctor. It doesn't matter if the form is ours or has another brand, logo, or colour on it. We will do our absolute best to accommodate all patients and get your exam completed at your earliest convenience.

What is the Purpose of a Requisition Form?

Requisition forms, sometimes called referral forms, are used by your doctor to communicate precisely what type of exam you require for a medical assessment. These forms direct our technologists by outlining where diagnostic imaging is needed, such as your right shoulder or left ankle. They also provide our team with important patient history and relevant information that may impact how your exam is performed. Something that might seem trivial to you, such as diabetes, possible pregnancy, or specific medication, can have a significant impact on the procedure or exam results.

Our Requisition Forms

The Toronto Queensway Ultrasound and X-Ray requision form can be filled out online and emailed directly to Toronto Queensway Diagnaostic. Alternatively it can also be filled out and printed for your client to bring with them.

Requisition Form

The Patient Process

Understanding the process

Doctor Examination - At your examination, your doctor orders a radiology test (X-ray, or Ultrasound) to help diagnose and treat your medical problem. Schedule Appointment - Your doctor's office might schedule the test for you with us, or you can schedule or re-schedule the test with us yourself. Tests Performed - After the test is completed, MORE...


We make it easy! No matter your communication preference, we provide three easy ways to schedule your appointment: 1. Schedule an appointment online and we'll contact you as soon as possible! 2. Call Us and will be happy to schedule your appointment. 3. Your doctor's office staff can assist you with scheduling your appointment MORE...

What to bring

You will be required to bring your Requisition Form completed and signed by your doctor, your health card and ID with you. You may also be required to bring any previous, relevant imaging exams and reports performed outside of our facility. MORE...

Our Services


An ultrasound, also called sonography, is a diagnostic imaging exam that uses a small transducer (probe) and ultrasound gel to expose the body to high-frequency sound waves to create images of blood vessels, tissues and organs.


An X-ray is a diagnostic test uses small doses of radiation to produce images of internal tissues, bones and organs onto film.