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Personal Particulars
and Appointment Information
(bold
- mandatory field) |
| Name |
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| NRIC |
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| Patient Ref. No |
(if any) |
| Contact No. |
(home)
(mobile/ pager)
|
| E-Mail |
|
| Preferred
Date |
(dd/mm/yyyy)
|
| Preferred
Time |
(hh:mm am/pm)
|
| |
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| Alternate
Date |
(dd/mm/yyyy)
|
| Alternate Time |
(hh:mm am/pm)
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Deposit Payment
For overseas patients
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You can make an appointment either by phone (65-6789-8888), fax
(65-6505-6092) or via email form above.
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As you will need to make arrangements for travel, accommodation
and preparations for the scan, it is advised that you plan for
your appointment as early as possible.
-
You will need to place a S$1,000 deposit (S$1,070 inclusive of
7% GST) for the purchase of FDG tracer. The FDG tracer is needed
for the scan. This deposit is payable at least 48 hours before
the day of your appointment/scan.
-
If you are overseas or unable to come to the Centre, and would
like the payment of deposit to be debited from your credit card
account, please print out the
Authorization Form and fax it to us. This Form will
authorize the Centre to charge the payment for the deposit to
your credit card.
-
Please kindly note that deposit placed will NOT
be refundable if notice of cancellation is LESS than 48 hours
before your appointment/scan date.
-
You will be issued a receipt for the payment of the deposit when
we see you on the day of your appointment/scan.
For local patients
-
You can make an appointment either by coming to the Centre
personally, phone (65-6838-7943), fax (65-6738-4220) or via
email form above.
-
You will need to place a S$1,000 deposit (S$1,070 inclusive of
7% GST) for the purchase of FDG tracer. The FDG tracer is needed
for the scan. This deposit is payable at least 48 hours before
the day of your appointment/scan.
-
Please kindly note that deposit placed will NOT
be refundable if notice of cancellation is LESS than 48 hours
before your appointment/scan date.
-
You will be issued a receipt for the payment of the deposit
after the deposit has been made.
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