Get the free radiology order form - UW Medicine

RADIOLOGY ORDER FORM SCHEDULING: 2065987200 RAD CONSULT LINE: 2065980101FAX: 2065974004 www.uwmedicine.org/services/radiologyUniversity of Washington Medical Center 1959 NE Pacific Street, Seattle,

How to fill out radiology order form

How to fill out radiology order form

1. Start by entering the patient's demographic information, such as their full name, date of birth, gender, and contact information.
2. Specify the ordering physician's details, including their name, contact information, and any relevant identification numbers.
3. Indicate the date and time the order is being submitted.
4. Select the type of radiology study to be performed from the provided options. This may include X-rays, CT scans, MRIs, ultrasounds, etc.
5. Provide a brief clinical history or reason for ordering the radiology study. Include any symptoms, suspected diagnoses, or other relevant information.
6. Specify any additional instructions or special requirements for the radiology study, such as contrast dyes or specific body regions to be examined.
7. Include any relevant past medical history or known allergies that may impact the radiology procedure.
8. If necessary, include any supporting documentation or prior imaging studies for comparison.
9. Review the completed form for accuracy and completeness before submitting it to the designated department or facility.
10. Keep a copy of the filled-out radiology order form for your records.

Who needs radiology order form?

1. Radiology order forms are typically needed by healthcare providers, including physicians, surgeons, specialists, and other medical practitioners.
2. These forms are used to request radiology studies for their patients, helping diagnose and monitor various conditions.
3. In some cases, patients themselves may need to fill out a radiology order form if they are self-referring for a study or if their healthcare provider requires them to do so.
4. Ultimately, anyone who requires a radiology study to be performed on themselves or someone else would need to initiate the process by filling out a radiology order form.

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What is radiology order form?

The radiology order form is a document used by healthcare providers to request various radiology imaging tests for patients.

Who is required to file radiology order form?

Healthcare providers such as doctors, specialists, and other medical professionals are required to file the radiology order form.

How to fill out radiology order form?

The radiology order form should be filled out by providing the patient's information, reason for the test, specific type of imaging needed, and any relevant medical history.

What is the purpose of radiology order form?

The purpose of the radiology order form is to request specific imaging tests in order to diagnose, monitor, or treat various medical conditions.

What information must be reported on radiology order form?

The radiology order form must include patient's name, date of birth, medical history, reason for the test, type of imaging needed, and healthcare provider's contact information.