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Yttrium90 Microsphere Referral Form for Hepatocellular Carcinoma What are 90Y microspheres? Yttrium90 (90Y) is a 100% beta emitter with a tissue penetration of 2.5 mm and a physical half life of 64.1

How to fill out yttrium-90 microsphere referral form

How to fill out yttrium-90 microsphere referral form

1. Start by gathering all necessary patient information, such as name, age, and medical history.
2. Ensure that you have the correct referral form for yttrium-90 microsphere treatment.
3. Fill out the patient's personal details accurately, including their date of birth and contact information.
4. Provide a brief summary of the patient's medical condition and the reason for referral for yttrium-90 microsphere treatment.
5. Include any relevant diagnostic test results or imaging reports, such as CT scans or PET scans.
6. Ensure that the referring physician signs and dates the referral form.
7. Submit the completed referral form along with any supporting documents to the appropriate healthcare facility or specialist.
8. Keep a copy of the referral form for your records.

Who needs yttrium-90 microsphere referral form?

1. Yttrium-90 microsphere referral form is needed for patients who are being considered for yttrium-90 microsphere treatment.
2. This form is typically completed by referring physicians or healthcare providers who believe their patients may benefit from this treatment.
3. Yttrium-90 microsphere treatment is a targeted radiation therapy primarily used for liver cancer or metastatic liver tumors.
4. Therefore, patients diagnosed with liver cancer or those with metastatic liver tumors may require this referral form.

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What is yttrium-90 microsphere referral form?

Yttrium-90 microsphere referral form is a document used for referring patients for treatment with yttrium-90 microspheres.

Who is required to file yttrium-90 microsphere referral form?

Medical professionals such as oncologists and interventional radiologists are required to file yttrium-90 microsphere referral form.

How to fill out yttrium-90 microsphere referral form?

Yttrium-90 microsphere referral form must be completed with patient information, medical history, and treatment plan details.

What is the purpose of yttrium-90 microsphere referral form?

The purpose of yttrium-90 microsphere referral form is to provide necessary information for the treatment of patients with yttrium-90 microspheres.

What information must be reported on yttrium-90 microsphere referral form?

Patient's name, medical history, current condition, treatment plan, and referring physician information must be reported on yttrium-90 microsphere referral form.