• OBSTETRIC RADIOLOGY REQUEST - URGENT

    • Complete this form to request clinically urgent scans required within 24-48 hours of assessment. Routine ultrasounds should be arranged in the normal way to ensure those in high clinical need are prioritised.
    • By completing this form the referrer confirms that the referred is eligible for maternity health services under Section 88, and is scheduled to birth in a Counties Manukau facility.

    The following scan types are excluded, book community scan directly with provider:

    • Suspected miscarriage 
    • Dating scans / viability (pre-20 weeks)

     

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  • ECTOPIC PREGNANCY

    Ectopic pregnancy high-risk cases MUST be scanned the same day as an acute presentation. If a same-day scan cannot be arranged, the patient must be referred to the Emergency Department for assessment. In cases of low suspicion or non-acute presentations requiring early pregnancy scans, monitor HCG levels and arrange a routine obstetric ultrasound. All cases should be discussed with the on-call SMO to ensure appropriate management and follow-up. This form should not be used on weekends, as ultrasound services are unavailable.

    To refer now, click HERE

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  • If not already completed you can request a co-payment funding voucher here


  • Please note the following important information:

    - Due to high demand, appointments may not be available within the usual 48-hour timeframe. If there is a high clinical risk requiring prioritisation, please email us at referral@poac.co.nz with relevant details so we can review accordingly.


    - Travel outside the local area is often required. Please ensure this has been clearly communicated to the patient. If necessary, consider arranging a taxi chit to support access.

  • POAC Office Use

    Booking details and comments
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  • Unable to proceed:

    Unfortunately, this referral is not eligible for a POAC-coordinated ultrasound.  Please refer to a community radiology provider in a routine manner.

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