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FIBROSIS CONSULTATION
REFERRAL FORM
1231 NORTH TURTLE AVENUE
SARASOTA, FLORIDA 34237REFERRING PHYSICIAN:Name:
Address:
iPhone:NPI:Stateful:Zip:PATIENTS DEMOGRAPHICS:
Name:
Address:
iPhone:Statutes:Zip:INSURANCE
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What is fibroscan consultation?
Fibroscan consultation is a non-invasive technology that assesses the degree of liver fibrosis.
Who is required to file fibroscan consultation?
Patients with liver disease or at risk of liver disease are required to undergo fibroscan consultation.
How to fill out fibroscan consultation?
Fibroscan consultation is completed by a healthcare professional using a special device that measures liver stiffness.
What is the purpose of fibroscan consultation?
The purpose of fibroscan consultation is to assess the severity of liver fibrosis and monitor disease progression over time.
What information must be reported on fibroscan consultation?
Fibroscan consultation requires reporting of liver stiffness measurements and other relevant clinical information.
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