Self-Referral Bone Density Form | St Josephs Hospital - Newport South Wales
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Patient Self-Referral Form for Bone Density Scans (REMS)

With significant demand on the healthcare providers and the NHS, patients are finding it increasingly difficult to see a healthcare professional as well as accessing vital diagnostic services. As a result, patients are now seeking alternative sources.

When this involves a bone density scan (REMS), the Advanced Diagnostics Department at St Josephs Hospital can now offer a self-referral pathway for imaging for patients that meet the special criteria.


Eligibility

Please tick at least one

Symptoms


Responsible Clinician Details

You must provide details of a responsible clinician (GMC or HCPC registered) or surgery address for the results to go back for discussion.

Scan Quality & Safety Questions


Patient Declaration & Consent

- The details I have provided are correct to the best of my knowledge. - I understand that the scan report will be sent to my designated clinician within 48 hours and to me within 5 working days. - I agree it is my responsibility to discuss my results with the appropriate clinician. - I have read and understood the self-referral criteria.