Get the free PETCT SCAN REQUEST FORM - Cardiff - medicine cf ac

Jul 21, 2010 ... Cardiff, CF14 4XW. Tel No:029 20746880/1. Fax No:029 20746879. Failure to complete ALL relevant sections of this form may result in a delay.

How to fill out petct scan request form

How to fill out a PET/CT scan request form:

1. Start by carefully reading the instructions on the form. Make sure you understand the purpose of the form and why a PET/CT scan is being requested.
2. Fill in the personal information section accurately. This includes your full name, contact information, date of birth, and any other required identification details.
3. Provide the necessary medical information. This may include your medical history, current medications, and any specific symptoms or concerns that prompted the need for a PET/CT scan. Be as detailed as possible to help the medical professional understand the context of the request.
4. Indicate the reason for the PET/CT scan. This can be the suspected diagnosis or the specific condition that the healthcare provider wants to evaluate. If unsure, consult with your healthcare provider to ensure you correctly fill out this section.
5. Specify any relevant contraindications or allergies. If you have any known allergies to contrast agents or other substances used during the PET/CT scan, note them clearly on the form to prevent any complications.
6. If the form requires a referring physician, provide their full name, contact information, and any other details requested. This ensures that the scan results are sent to the appropriate healthcare professional.

Who needs a PET/CT scan request form:

1. Patients who have been referred by their primary care physician or specialist for further evaluation or diagnosis.
2. Individuals who have a medical condition or symptoms that require a PET/CT scan to determine the extent of the disease or evaluate treatment effectiveness.
3. Patients who are undergoing cancer treatment and require periodic scans to monitor the progress of their therapy.

Remember, it's essential to consult with your healthcare provider regarding the specific requirements and guidance for filling out the PET/CT scan request form.

For pdfFiller’s FAQs

What is petct scan request form?

The petct scan request form is a document used to request a PET-CT scan from a medical facility.

Who is required to file petct scan request form?

Patients or their healthcare providers are required to file a petct scan request form.

How to fill out petct scan request form?

The petct scan request form can be filled out by providing patient information, reason for the scan, and any other relevant details.

What is the purpose of petct scan request form?

The purpose of the petct scan request form is to request a PET-CT scan for medical diagnosis or treatment planning.

What information must be reported on petct scan request form?

The information reported on the petct scan request form typically includes patient demographics, medical history, and reason for the scan.

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