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THE HOSPITAL FOR SICK CHILDREN Request for Diagnostic Imaging For MRI Please complete Request for MRI Form For IT Please complete Request for IT Form See reverse for the Modality contact information
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How to fill out request for diagnostic imaging
How to fill out a request for diagnostic imaging:
01
Start by obtaining the necessary referral form from your healthcare provider. This form will typically include your personal information, such as your name, date of birth, and contact details.
02
Fill in your healthcare provider's information, including their name, clinic or hospital address, phone number, and any other required contact information.
03
Specify the type of diagnostic imaging you are requesting. This could include X-rays, MRI scans, CT scans, ultrasounds, or any other imaging modality.
04
Describe the reason for your request in detail. Provide relevant information about your symptoms, medical history, and any previous test results that may assist the radiologist in making an accurate diagnosis.
05
Indicate the urgency of your request. If the imaging is needed urgently, ensure that this is clearly stated to expedite the process.
06
If you have any specific instructions or preferences, such as a particular imaging facility or radiologist, include these details in the request form.
Who needs a request for diagnostic imaging?
01
Patients: Individuals who are experiencing symptoms or have been referred by their healthcare provider for further investigation may need a request for diagnostic imaging. This can aid in the diagnosis and treatment of various medical conditions.
02
Healthcare providers: Doctors, specialists, or healthcare professionals who suspect a specific condition and require imaging to confirm their diagnosis often issue requests for diagnostic imaging.
03
Insurance providers: In some cases, insurance companies require a valid request for diagnostic imaging in order to cover the cost of the procedure. This helps ensure that the imaging is medically necessary and appropriate.
It is important to note that the specific requirements and procedures for filling out a request for diagnostic imaging may vary depending on the healthcare system or country in which you are located. It is advised to follow the guidelines provided by your healthcare provider or consult the appropriate authority for accurate and up-to-date information.
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What is request for diagnostic imaging?
A request for diagnostic imaging is a formal document submitted by a healthcare provider to authorize the performance of imaging studies such as X-rays, MRI, CT scans, etc.
Who is required to file request for diagnostic imaging?
Healthcare providers such as doctors, radiologists, or other medical professionals are required to file a request for diagnostic imaging.
How to fill out request for diagnostic imaging?
The request for diagnostic imaging should include the patient's information, the specific type of imaging study requested, the reason for the study, and any relevant clinical information.
What is the purpose of request for diagnostic imaging?
The purpose of a request for diagnostic imaging is to provide necessary information for the performance of imaging studies to aid in the diagnosis and treatment of medical conditions.
What information must be reported on request for diagnostic imaging?
The request for diagnostic imaging must include the patient's name, date of birth, medical history, referring physician's information, type of study requested, reason for the study, and any relevant clinical information.
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