Get the free AM NHS Guild PETCT Pat Req Frm Sep13 aw:NHS FAQ Mar 08 30/09/2013 16:23 Page 1 PET/C...
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AM NHS Guild PET CT Pat Req FRM Sep13 aw:NHS FAQ Mar 08 30/09/2013 16:23-Page 1 PET/CT Patient Request Form Please send completed request forms along with previous relevant imaging reports to: Guildford
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How to fill out am nhs guild petct
How to fill out an NHS Guild PET-CT:
01
Gather all necessary information and documents, including your personal details, medical history, and referral form from your healthcare professional.
02
Make sure you have a clear understanding of the form's sections and what information needs to be provided for each.
03
Begin by filling out the basic personal details section, including your name, address, date of birth, and contact information.
04
Move on to the medical history section, where you will be asked about any previous illnesses, surgeries, or medical conditions you may have.
05
Provide accurate information about any medications you are currently taking, including dosage and frequency.
06
If applicable, indicate any known allergies or intolerances to medications or substances.
07
Fill out the referral information, including your healthcare professional's name, clinic or hospital details, and any relevant contact information.
08
Ensure that you have included all necessary supporting documents, such as copies of previous imaging scans or relevant medical reports.
09
Double-check your form for any errors or missing information before submitting it. If in doubt, consult with your healthcare professional or the appropriate staff at the NHS Guild PET-CT center.
10
Submit the completed form as per the instructions provided, whether it be via mail, email, or in-person.
Who needs an NHS Guild PET-CT?
01
Individuals who have been referred by their healthcare professional for further diagnostic evaluation and staging of specific medical conditions.
02
Patients who have suspected cancer or have a history of cancer and require accurate imaging results for treatment planning purposes.
03
Individuals who have undergone previous medical treatments and require follow-up imaging to assess treatment effectiveness or detect any potential recurrence.
04
Patients with certain neurological disorders that may benefit from PET-CT imaging, such as epilepsy or Alzheimer's disease.
05
Individuals participating in clinical trials or research studies where PET-CT scans are necessary for monitoring treatment outcomes.
06
Patients with certain cardiac conditions that may require PET-CT imaging for assessing heart function or myocardial viability.
07
Individuals with suspected infectious diseases that may be visualized through PET-CT scans, such as tuberculosis or certain types of abscesses.
08
Patients who have been referred for pre-operative planning or radiation therapy treatment preparation.
09
Individuals who are undergoing PET-CT as part of a routine health screening or preventive care program, as recommended by their healthcare professional.
10
Patients whose healthcare team believes that PET-CT imaging is necessary for a more accurate diagnosis or monitoring of their medical condition.
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