Get the free ImagingForm-DOH345-212-Jan2018. Form for recording the imaging results for a breast ...
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SPOKANE REGIONAL HEALTH DISTRICT
PHONE 5093232851
FAX 5093241599
WWW.RHD.ORG
DOH 345212 Jan 2018IMAGING BREAST EVALUATION REPORTING FORM
Please Print Clearly
CLIENT NAME (Last, First, MI)BC CHP#
DATE
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How to fill out imagingform-doh345-212-jan2018 form for recording
01
To fill out the imagingform-doh345-212-jan2018 form for recording, follow these steps:
02
Obtain a copy of the form from the designated source, such as the Department of Health website or a medical facility.
03
Read the instructions provided with the form carefully to understand the purpose and requirements of each section.
04
Start by entering the patient's information in the designated fields, including their name, date of birth, and contact details.
05
Provide relevant medical history, if required, in the specified section.
06
Follow the guidelines mentioned to record the specific imaging procedure being performed.
07
Ensure to accurately document the details of the imaging procedure, including the date, time, and location.
08
If applicable, note the equipment used and any contrast agents or medications administered during the procedure.
09
Fill out the pertinent findings or observations made during the imaging process.
10
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12
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Who needs imagingform-doh345-212-jan2018 form for recording?
01
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02
This may include radiologists, diagnostic imaging technicians, physicians, or other healthcare providers who utilize imaging techniques to diagnose and monitor patients.
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The form helps ensure that accurate and standardized records are maintained for each imaging procedure, allowing for effective communication, continuity of care, and future reference if needed.
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