Evergreen Health Interventional Radiology Order Form free printable template

This form is used to order radiological interventions, including requests for biopsies, drains, and other procedures. It requires patient information, diagnosis details, and lab results to be submitted

How to fill out evergreen interventional form

How to fill out Evergreen Health Interventional Radiology Order Form

1. Obtain the Evergreen Health Interventional Radiology Order Form from the relevant department or website.
2. Fill in the patient's personal information, including name, date of birth, and medical record number.
3. Specify the referring physician's name and contact information.
4. Select the specific interventional radiology procedure(s) needed from the provided list.
5. Provide detailed clinical history and indication for the procedure.
6. Include any relevant imaging studies or results that support the request.
7. Fill in the patient's insurance information, if applicable.
8. Sign and date the form at the bottom.
9. Submit the completed form to the appropriate department or personnel.

Who needs Evergreen Health Interventional Radiology Order Form?

1. Physicians or healthcare providers referring patients for interventional radiology procedures.
2. Patients requiring specific procedures or treatments from Evergreen Health's interventional radiology department.
3. Administrative staff managing patient referrals and approvals for interventional radiology services.

People Also Ask about interventional form print

How hard is it to get into interventional radiology?

Interventional radiology is one of the more competitive specialties in matching into a residency program. Each year, thousands of hopeful medical school graduates apply for a limited number of positions in their preferred specialty.

What is the purpose of interventional imaging procedures?

Interventional radiologists diagnose and treat disease. They treat a wide range of conditions in the body by inserting various small tools, such as catheters or wires from outside the body. X-ray and imaging techniques such as CT and ultrasound help guide the radiologist.

How do I prepare for interventional radiology?

General Interventional Radiology Preparation Do not eat or drink after midnight before procedure. Morning of procedure, take blood pressure and/or heart medications with a sip of water unless told otherwise. You will not be allowed to drive after procedure so please arrange transportation.

What documentation is required for interventional radiology?

Documentation of each patient encounter should include the following: the date, an appropriate history and physical exam, results of laboratory and imaging studies, and an assessment and plan for care, including reasons for tests, as well as discharge planning and instructions to patient when appropriate.

What is the purpose of interventional radiology?

The concept behind interventional radiology is to diagnose and treat patients using the least invasive techniques currently available in order to minimize risk to the patient and improve health outcomes. These procedures have less risk, less pain and less recovery time in comparison to open surgery.

What cases are done in interventional radiology?

Interventional Radiology Ablations — lung, liver, renal (kidney) or spine. Angiography. Chemoembolization. Fistulagram — dialysis. Interventional oncology. Internal radiation therapy for the liver. Prostate artery embolization. Uterine fibroid embolization.

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What is Evergreen Health Interventional Radiology Order Form?

The Evergreen Health Interventional Radiology Order Form is a document used by healthcare professionals to request interventional radiology procedures for patients.

Who is required to file Evergreen Health Interventional Radiology Order Form?

Healthcare providers, such as physicians or surgeons, who are referring patients for interventional radiology procedures are required to file the form.

How to fill out Evergreen Health Interventional Radiology Order Form?

To fill out the Evergreen Health Interventional Radiology Order Form, the provider must enter patient information, specify the requested procedure, provide relevant medical history, and sign the form.

What is the purpose of Evergreen Health Interventional Radiology Order Form?

The purpose of the Evergreen Health Interventional Radiology Order Form is to streamline the communication between referring providers and interventional radiology departments, ensuring appropriate care and documentation.

What information must be reported on Evergreen Health Interventional Radiology Order Form?

The information that must be reported includes the patient's personal details, procedure details, clinical indications for the procedure, and any necessary prior imaging or history related to the condition being treated.