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Appointment Requests

Phone

Toll Free
1-877-420-4232

Calgary & Area
403-212-5855

Edmonton & Area
780-341-6000

MRI/CT
403-212-5847

Request to Book Your Appointment

Provide your information and we will call you to book. We will call you within 24-48 hours (Mon-Sat).

Your Name*
First Last
Email*
Phone Number*
Date of Birth*

Day
Month
Year
Personal Health Number

*Provincial Health Care Number
Exams Required (list all that apply)*
- MRI & CT
- Pain Management
- Ultrasound
- Breast Imaging
- Gi Studies
- Bone Mineral Desitometry
- Kid's Imaging
- X-Ray
- Nuclear Medicine Imaging
Location
Please select your preferred location.
Privacy*
Canada Diagnostic Centres is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide products and services you requested from us. By clicking I agree, you consent to allow Canada Diagnostic Centres to store and process the personal information submitted above to provide you the service requested.
- I agree to submit my personal information so I may by called to book an appointment
Requisition Form
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Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 10 MB, Max. files: 2.
Please upload a photo or scan of your requisition form. Please note, online upload is not a 100% secure method of communication. By submitting this appointment request form, you understand the risks of submitting information online.
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Cancel Your Appointment

To cancel an existing appointment please provide your information below. * Please call in if cancellation is within 24 business hours of appointment.

Your Name*
First Last
Email*
Phone Number*
Date of Birth*

Day
Month
Year
Personal Health Number

*Provincial Health Care Number
Location
Please select which location your appointment was scheduled at.
Appointment Date*
DD slash MM slash YYYY
Cancellation handling*
- I request a call back to reschedule my appointment
- Cancel, I will call back at a later date
Privacy*
Canada Diagnostic Centres is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide products and services you requested from us. By clicking I agree, you consent to allow Canada Diagnostic Centres to store and process the personal information submitted above to provide you the service requested.
- I agree to submit my personal information so I may by called to book an appointment
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Fax

Fax us a copy of your requisition form and we will call you to book.

Fax (Toll-Free)
1-877-919-3291

Fax (Calgary & Area)
403-253-4669

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Toll Free: 1.877.420.4232 (4CDC)
Calgary & Okotoks: 403.212.5855
Edmonton & Sherwood Park: 780.341.6000

Find Location Book Appointment

General Radiology

Do you have the following license or certification: Diagnostic Radiology?*
- Yes
- No
Do you have College of Physicians & Surgeons of Alberta licensure or eligibility (Diagnostic Radiology including U/S)?*
- Yes
- No
Are you a Fellow of Royal College of Physicians & Surgeons of Canada (Diagnostic Radiology)?*
- Yes
- No
How many years of work experience do you have using MRI?
How many years of work experience do you have using Breast Imaging?
How many years of work experience do you have using Patient Care?
How many years of work experience do you have using Clinical Care?
How many years of work experience do you have using BMD?
First Name*
Last Name*
Email*
Phone Number*
Upload Cover Letter/Resume
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Max. file size: 10 MB, Max. files: 3.

Breast Imaging Radiology

Do you have Canadian Association of Radiologists mammography accreditation or eligibility?*
- Yes
- No
Do you have College of Physicians & Surgeons of Alberta licensure or eligibility (Diagnostic Radiology including U/S)?*
- Yes
- No
Are you a Fellow of Royal College of Physicians & Surgeons of Canada (Diagnostic Radiology)?*
- Yes
- No
First Name*
Last Name*
Email*
Phone number
Upload Cover Letter/Resume
Drop files here or

Max. file size: 10 MB, Max. files: 3.