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Get the free Outside Physician Order for Radiology/Nuclear Medicine - uihealthcare

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This document is a request form for procedures in the Department of Radiology at the University of Iowa Hospitals and Clinics, collecting patient information, procedure details, and physician requests.
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How to fill out outside physician order for

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How to fill out Outside Physician Order for Radiology/Nuclear Medicine

01
Obtain the Outside Physician Order form from the designated source.
02
Fill in the patient's personal information, including name, date of birth, and contact details.
03
Provide the referring physician's information, including name, contact number, and address.
04
Specify the type of radiology or nuclear medicine procedure required.
05
Include relevant clinical information or diagnosis to support the order.
06
Check for any required authorizations or insurance information.
07
Sign and date the order form.
08
Submit the completed form to the appropriate radiology or nuclear medicine department.

Who needs Outside Physician Order for Radiology/Nuclear Medicine?

01
Patients being referred for radiology or nuclear medicine services by an outside physician.
02
Referring physicians or healthcare providers who require essential imaging services for their patients.
03
Insurance companies may require the order for verification and authorization purposes.
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People Also Ask about

Preparation is generally not required before a nuclear medicine test, but occasionally you will be asked to fast for 2–4 hours prior to the scan. This will depend on the type of nuclear medicine scan being performed.
Nuclear Stress Testing Do not eat or drink for four hours prior. If you are scheduled for a pharmacologic stress test, refrain from caffeine products 24 hours prior to the exam.
Harvard University. United StatesCambridge (U.S.) Stanford University. United StatesStanford. Radboud University Nijmegen. NetherlandsNijmegen. Ruprecht Karls University Heidelberg. GermanyHeidelberg. University College London. Imperial College London. Johns Hopkins University. University of Pennsylvania.
Nothing to eat or drink (NPO) for 6 hours before stress test. 2-day protocol: Rest scan (2 hours) is scheduled in the afternoon with stress scans (2.5 hours) the next morning. 1-day protocol: Rest scan is done first in Nuclear Medicine.
You may be asked not to eat, drink or smoke for a time before a nuclear stress test. You may need to avoid caffeine the day before and the day of the test. Ask your healthcare team if you need to stop taking any medicines before the test. Some medicines can interfere with some test results.
Doctors in nuclear medicine use radioactive substances to examine, diagnose and treat patients with life-threatening or chronic conditions. You'll be hospital-based and often integrated with colleagues in radiology and/or oncology departments.
Nuclear medicine is a specialized area of radiology. It uses very small amounts of a radioactive substance (radionuclide or radio-tracer) for health research, diagnosis, and treatment of various conditions, including cancer. Nuclear medicine imaging is a mix of many different disciplines.
Nothing to eat or drink (NPO) for 6 hours before stress test. 2-day protocol: Rest scan (2 hours) is scheduled in the afternoon with stress scans (2.5 hours) the next morning. 1-day protocol: Rest scan is done first in Nuclear Medicine.

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The Outside Physician Order for Radiology/Nuclear Medicine is a formal document used to request radiological or nuclear medicine services from external physicians outside the primary healthcare facility.
Any physician who is not part of the primary healthcare facility but is referring a patient for radiological or nuclear medicine services is required to file an Outside Physician Order.
To fill out the Outside Physician Order, the referring physician must complete the designated form including patient information, specifics of the requested services, and any relevant clinical details.
The purpose of the Outside Physician Order is to ensure that radiological or nuclear medicine procedures are accurately requested and documented, facilitating patient care and ensuring appropriate clinical follow-up.
Essential information to be reported includes patient demographics, physician details, specific exams requested, clinical history, and any additional notes that may assist in the procedure.
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