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What is Imaging Referral Form

The Musculoskeletal Imaging Referral Form is a medical document used by healthcare providers to schedule appointments for musculoskeletal imaging procedures in New Zealand.

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Who needs Imaging Referral Form?

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Imaging Referral Form is needed by:
  • Referring healthcare professionals.
  • Patients requiring musculoskeletal imaging.
  • Medical facilities offering imaging services.
  • Radiologists interpreting imaging results.
  • Administrative staff managing referrals.

How to fill out the Imaging Referral Form

  1. 1.
    To access the Musculoskeletal Imaging Referral Form, visit the pdfFiller website and use the search function to find the form by name or category.
  2. 2.
    Once the form is open, familiarize yourself with the available fillable fields.
  3. 3.
    Gather key information such as the patient's surname, first names, date of birth, phone number, and address.
  4. 4.
    Prepare the NHI number, procedure details, and a brief clinical history about the patient's condition to complete relevant sections accurately.
  5. 5.
    Next, enter the patient's details in the designated fields, ensuring all information is spelled correctly and accurately reflects the patient’s records.
  6. 6.
    After filling in the patient’s information, input the procedure required and relevant clinical details as requested on the form.
  7. 7.
    Review the information entered carefully to avoid errors. Check all sections, especially the referrer’s name, practice address, and signature field.
  8. 8.
    Once confirmed, follow pdfFiller’s prompts to finalize the document, ensuring all necessary signatures are collected.
  9. 9.
    You can save the completed form as a PDF or download it to your device for printing.
  10. 10.
    If required, submit the form directly through pdfFiller, or print it to bring to the appointment.
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FAQs

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The Musculoskeletal Imaging Referral Form is typically filled out by healthcare professionals, such as doctors or specialists, who are referring patients for imaging procedures.
Before starting, gather the patient's personal information, NHI number, details of the procedure, and any relevant clinical history necessary to complete the Musculoskeletal Imaging Referral Form accurately.
After filling out the form, you can submit it through the pdfFiller platform or print it out for physical submission at the corresponding medical facility.
Ensure that all fields are filled out completely and accurately, particularly patient information and procedure details. Double-check for spelling errors and verify that the referrer’s signature is included.
No, notarization is not required for the Musculoskeletal Imaging Referral Form, but it must be signed by the referrer before submission.
Omitting the NHI number may delay processing or scheduling of the imaging procedure, so it’s crucial to include it when filling out the form.
Processing times can vary, but it typically takes a few business days for the medical facility to review and schedule an appointment for imaging after receiving the referral.
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