Get the free X-ray reciprocity request application - colorado
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State of Colorado Department of Public Health & Environment Application for X-Ray Reciprocity Request INSTRUCTIONS: This application must be printed in ink and have original signatures and dates.
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What is x-ray reciprocity request application?
The x-ray reciprocity request application is a form used to request reciprocity for x-ray imaging conducted in a different jurisdiction.
Who is required to file x-ray reciprocity request application?
Anyone who has had x-ray imaging done in a different jurisdiction and wishes to have the results recognized in their current jurisdiction.
How to fill out x-ray reciprocity request application?
The x-ray reciprocity request application can typically be filled out online or in person, and requires relevant information such as the type of x-ray imaging done and where it was conducted.
What is the purpose of x-ray reciprocity request application?
The purpose of the x-ray reciprocity request application is to ensure that x-ray imaging results obtained in one jurisdiction are recognized and accepted in another jurisdiction.
What information must be reported on x-ray reciprocity request application?
The x-ray reciprocity request application typically requires information such as the date of the x-ray imaging, the name of the healthcare provider or facility where it was done, and any relevant medical history.
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