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Harrison Imaging CentersBreast Imaging Referral Form Phone: (360) 3376500 / (800) 9729264 Fax (360) 6625501 Appointment Date: Checking Time: Location:See reverse for maps. Silver dale Port Orchard
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What is breast imaging referral form?
The breast imaging referral form is a document used to request imaging tests of the breast such as mammograms.
Who is required to file breast imaging referral form?
Healthcare providers, such as doctors or specialists, are usually the ones required to file the breast imaging referral form.
How to fill out breast imaging referral form?
To fill out the breast imaging referral form, one must provide patient information, medical history, reason for referral, and any relevant clinical notes.
What is the purpose of breast imaging referral form?
The purpose of the breast imaging referral form is to request imaging tests for the detection and diagnosis of breast conditions, including breast cancer.
What information must be reported on breast imaging referral form?
The breast imaging referral form must include patient demographics, referring physician information, reason for referral, relevant medical history, and preferred imaging tests.
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