Alliance Medical Imaging Centre
10-11 Bulstrode Place
London
W1U 2HX

T: +44 (0)20 7935 7711
F: +44 (0)20 7935 7715
E: London@alliance.co.uk
 

If you are a Clinician and would like to refer a patient to the Alliance Medical Imaging Centre in London, you can download our scan request forms below:

PET and PET/CT scan request form download
MRI, CT and X-Ray scan request form download

To read these files you will need Adobe Acrobat Reader, you can download this free of charge from their website: www.adobe.com.