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CT RADIOLOGY OUTPATIENT COMPUTED TOMOGRAPHY REQUISITION MR MISS Surname MRS MS Permanent address Postal code Cell phone DOB SPH: Fax to 604 806 8437 MSC: Fax to 6048778132 First name Postal code Cell

How to fill out outpatient computed tomography requisition

1. To fill out an outpatient computed tomography (CT) requisition, you will need to follow these steps:
2. Fill out the patient information section: Locate the designated area on the requisition form where you can input the patient's details. Write the patient's full name, date of birth, and contact information accurately. This section helps to ensure that the CT scan results are correctly associated with the correct individual.
3. Provide the reason for the CT scan: In the requisition form, there should be a space to explain the clinical indication or reason for the CT scan. Include any relevant medical history or symptoms that led to the decision of ordering the CT scan. The more specific and detailed this section is, the easier it will be for the radiologist to interpret the results.
4. Specify the body part to be scanned: Indicate the exact body part or area that needs to be imaged in the CT scan. You can either select a pre-determined option or write it out explicitly. Take care to be accurate and clear to ensure the radiologist focuses on the correct area.
5. Ensure all necessary checkboxes are marked: The requisition form may include checkboxes related to contrast administration, IV access requirements, or any additional specific instructions. Carefully review and mark the checkboxes accordingly based on the patient's needs and the instructions provided by the referring physician.
6. Include any additional instructions: If there are any special instructions or considerations for the CT scan, provide them in the designated section of the requisition form. This may include fasting requirements, medication adjustments, or any other relevant information needed to carry out the procedure safely and accurately.

As for who needs an outpatient computed tomography requisition, it is typically required for patients who have been referred by their healthcare provider. This could include individuals experiencing certain symptoms or medical conditions that necessitate further investigation through a CT scan. The decision to order a CT scan is made by the referring physician or healthcare professional based on their clinical judgment, considering the potential benefits and risks associated with the procedure. It is important to consult with a healthcare provider to determine if a CT scan is necessary for a specific individual.

For pdfFiller’s FAQs

What is outpatient computed tomography requisition?

Outpatient computed tomography requisition is a request for a CT scan procedure that is made by a healthcare provider for a patient who does not require hospitalization.

Who is required to file outpatient computed tomography requisition?

The healthcare provider or physician who is ordering the CT scan procedure is required to file the outpatient computed tomography requisition.

How to fill out outpatient computed tomography requisition?

The outpatient computed tomography requisition form must be filled out by providing the patient's information, the reason for the CT scan, any relevant medical history, and the ordering provider's details.

What is the purpose of outpatient computed tomography requisition?

The purpose of outpatient computed tomography requisition is to request a CT scan procedure for a patient who can undergo the imaging study without being admitted to a hospital.

What information must be reported on outpatient computed tomography requisition?

The outpatient computed tomography requisition must include the patient's name, date of birth, medical history, reason for the CT scan, ordering provider's name and contact information, and any relevant clinical notes.

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