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PATIENT REGISTRATION FORM **OFFICE USE ONLY** TODAY S DATE: MR#: LAST NAME: FIRST NAME: ADDRESS: APT: CITY: STATE: ZIP CODE: HOME PHONE #: () — CELL PHONE #: () — DATE OF BIRTH: SEX: Male Female
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What is pet ct packet form?
PET CT packet form is a documentation form that is used to report information related to PET-CT scans, including patient information, scan details, and results.
Who is required to file pet ct packet form?
Medical facilities or practitioners who perform PET-CT scans are required to file the PET CT packet form.
How to fill out pet ct packet form?
The PET CT packet form can be filled out by providing the necessary information, such as patient details, scan date, scan type, radiopharmaceutical used, and scan results.
What is the purpose of pet ct packet form?
The purpose of the PET CT packet form is to ensure accurate reporting and documentation of PET-CT scan information for medical and regulatory purposes.
What information must be reported on pet ct packet form?
The PET CT packet form requires reporting of information such as patient demographics, referring physician details, scan procedure details, radiopharmaceutical information, and scan results.
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