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Imaging Request Form FAX: 0845 6171335 Patient Name/Label: Home Tel: Address: Mobile Tel: Postcode: Date of Birth: Patient NHS No: Work Tel: e-mail: Body Part to Be Imaged Examination Requested If

How to fill out imaging request form fax

How to fill out imaging request form fax:

1. Start by filling out the top section of the form with your personal information such as your name, contact number, and address.
2. In the next section, provide details about the imaging request, including the type of images needed, the purpose of the request, and any specific instructions or requirements.
3. If applicable, indicate the date and time when the requested images are needed by, as well as any urgency or priority attached to the request.
4. Make sure to include any relevant medical or patient information, such as the patient's name, medical record number, and the healthcare provider's contact information.
5. Double-check all the information you have entered to ensure accuracy and completeness.
6. Once you have completed filling out the form, make a copy for your records before sending it via fax to the designated fax number.
7. Follow up with the recipient of the fax to ensure they have received the form and to confirm any additional steps or requirements.

Who needs imaging request form fax:

1. Healthcare providers: Doctors, specialists, and other healthcare professionals often need to request imaging services for their patients. Using a fax form ensures that the request is documented and easily transmitted to the imaging department.
2. Patients: In some cases, patients may be required to fill out a fax form to request their own imaging services, such as for a second opinion or to obtain images for personal records.
3. Imaging departments: The fax form acts as a formal request for imaging services and serves as a record for the imaging department. It provides them with all the necessary information to schedule and perform the requested imaging procedures.

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What is imaging request form fax?

The imaging request form fax is a document used to request imaging services via fax.

Who is required to file imaging request form fax?

Any individual or organization in need of imaging services is required to file the imaging request form via fax.

How to fill out imaging request form fax?

To fill out the imaging request form fax, provide all necessary information requested on the form, including contact details, imaging service needed, and any other relevant information.

What is the purpose of imaging request form fax?

The purpose of the imaging request form fax is to streamline the process of requesting imaging services and ensure all necessary information is provided.

What information must be reported on imaging request form fax?

The imaging request form fax must include contact details, type of imaging service needed, any specific instructions, and any other relevant information.