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Brockville General Hospital fax number
(855) 564-1878
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Diagnostic Imaging and Cardiovascular Services - Ultrasound
Used for: Submitting ultrasound requisitions to schedule ultrasound examinations.
Fax destination details
- Department
- Diagnostic Imaging and Cardiovascular Services - Ultrasound
- Purpose
- Submitting ultrasound requisitions to schedule ultrasound examinations.
- Form
- Ultrasound Requisition — Ultrasound Requisition Form
- Address
- 75 Charles St., Brockville, ON K6V 1S8, Canada
- Voice phone
- 613-345-5649
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fill in patient information, date, referring clinician name and signature, and the clinician fax number. Use the Brockville General Hospital-specific requisition form and fax to the number 855-564-1878.
Official form instructions are published as a downloadable file on the organization's website.
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