Get the free OUTPATIENT ULTRASOUND REFERRAL - mspca.org

Diagnostic Imaging Department 350 S. Huntington Ave., Boston, Ma 02130 Phone (617) 5415139 Fax (617) 9891617OUTPATIENT ULTRASOUND REFERRAL Please fill out and fax this form to 6179891617 before calling

How to fill out outpatient ultrasound referral

How to fill out outpatient ultrasound referral

1. Start by gathering the necessary patient information, such as their name, date of birth, and contact details.
2. Determine the reason for the outpatient ultrasound referral and the specific area of the body that needs to be examined.
3. Complete the referral form provided by the ultrasound facility. Make sure to accurately fill in the patient's information and the referring physician's details.
4. Provide relevant medical history, including any previous imaging results or relevant lab tests.
5. Clearly state the clinical question or suspected diagnosis that necessitates the ultrasound examination.
6. Specify any additional instructions or requirements, such as fasting or preparation procedures for the patient.
7. Sign and date the referral form, ensuring that it is legible and easily recognizable as coming from the referring physician.
8. Submit the completed referral form either electronically or by hand to the designated ultrasound facility.
9. Inform the patient about the referral and provide them with any necessary appointment details or instructions.
10. Follow up with the ultrasound facility to ensure that the referral was received and processed.

Who needs outpatient ultrasound referral?

1. Patients who require further diagnostic evaluation or monitoring of specific body areas or conditions may need an outpatient ultrasound referral.
2. Common examples include individuals with suspected gallbladder or kidney stones, pregnant women needing prenatal ultrasound assessments, patients with suspected liver or spleen abnormalities, or those with symptoms requiring evaluation of the thyroid gland.
3. Ultimately, the decision to refer a patient for an outpatient ultrasound depends on the healthcare provider's judgment based on the patient's medical history, symptoms, and physical examination findings.

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What is outpatient ultrasound referral?

Outpatient ultrasound referral is a request from a healthcare provider for a patient to undergo an ultrasound examination at a medical facility outside of a hospital setting.

Who is required to file outpatient ultrasound referral?

Healthcare providers such as doctors, nurse practitioners, or physician assistants are required to file outpatient ultrasound referrals for their patients.

How to fill out outpatient ultrasound referral?

Outpatient ultrasound referral can be filled out by providing the patient's demographic information, medical history, reason for the referral, and any specific instructions for the ultrasound examination.

What is the purpose of outpatient ultrasound referral?

The purpose of outpatient ultrasound referral is to diagnose or monitor medical conditions by obtaining detailed images of internal organs and tissues.

What information must be reported on outpatient ultrasound referral?

The information reported on outpatient ultrasound referral includes patient's name, date of birth, referring provider's information, reason for the referral, and any relevant medical history.