@jeffmarc We are in Canada and when my husband's PSA went up considerably, I asked for a PSMA since he was going to be seeing a radiologist and oncologist within the next couple of weeks. Our urologist said that the only way we would get a PSMA would be if my husband was part of a clinical trial. He was not and I didn't want to waste time, so we eventually got a requisition and went to a private institution. I am thankful that we did because that gave the locations of the metastases to the radiologist and oncologist. I am frustrated that they wouldn't have just provided the PSMA for us, but, whatever the case, we got it and I am so thankful we did.