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How to fill out requisition for spasticity assessment

1. To fill out a requisition for spasticity assessment, start by gathering all the necessary information. This includes the patient's full name, date of birth, contact details, and any relevant medical history.
2. Make sure to include the referral source, whether it is a general practitioner, neurologist, physiatrist, or any other medical professional involved in the patient's care.
3. Specify the reason for the spasticity assessment. This could be to evaluate the effectiveness of current treatment methods, to investigate the cause of spasticity, or to develop a comprehensive management plan.
4. Provide a brief summary of the patient's symptoms and any previous treatments or interventions that have been tried. Include information about medications, therapies, or other approaches used to manage spasticity.
5. Indicate any relevant diagnostic tests or imaging studies that have been conducted or are planned, such as EMG (electromyography), MRI (magnetic resonance imaging), or nerve conduction studies.
6. Specify any additional information or documentation that should accompany the requisition, such as medical reports, imaging results, or other relevant records.
7. Clearly state the name and contact information of the healthcare provider who will be conducting the spasticity assessment. This could be a neurologist, physical therapist, or rehabilitation specialist.
8. Finally, review the completed requisition form for accuracy and completeness before submitting it.

Who needs a requisition for spasticity assessment?

1. Patients who are experiencing spasticity symptoms, such as muscle stiffness, spasms, or difficulty with movement, may require a requisition for spasticity assessment.
2. General practitioners or primary care physicians may issue a requisition for spasticity assessment if they suspect a neurological condition or if conservative management approaches have been unsuccessful.
3. Neurologists, physiatrists, or rehabilitation specialists may also request a spasticity assessment to further evaluate and manage patients with existing neurological or musculoskeletal conditions.
4. In some cases, insurance companies or healthcare facilities may require a requisition for spasticity assessment to document the medical necessity of the evaluation and ensure appropriate reimbursement or coverage.
5. Ultimately, the decision to request a requisition for spasticity assessment depends on the individual patient's needs, symptoms, and the healthcare provider's clinical judgment.

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