Get the free ARI Podiatric MRI Request Form - Atlantic Radiologic Imaging

345 Sea view Avenue Staten Island, NY 10305 TEL: 718-980-4888 FAX: 718-980-4873 AtlanticRadiology GMail.com ARIMRI.COM ATLANTIC RADIOLOGIC IMAGING PEDIATRIC MRI REQUEST FORM Patient Name: Date of

How to fill out ari podiatric mri request

Instructions for filling out an ARI Podiatric MRI request:

1. Start with the patient information section. Provide the patient's full name, date of birth, gender, address, and contact information. It is important to ensure accuracy and legibility when entering this information.
2. Move on to the referring physician information. Include the referring physician's name, specialty, contact information, and any additional details that may be required, such as their National Provider Identifier (NPI) number.
3. Next, specify the reason for the MRI request. Clearly state the suspected diagnosis or the specific condition for which the MRI is being requested. Provide any relevant clinical history or findings that support the need for the MRI.
4. Indicate the desired imaging study. Clearly state whether a specific area or multiple areas need to be imaged. For instance, you may request an MRI of the foot, ankle, or both. Specify if any specific sequences or techniques are required for the study.
5. Include any additional instructions or preferences for the MRI study. This may include patient positioning, contrast administration, or any specific imaging protocols that should be followed. Be as detailed as possible to ensure the desired results.
6. Specify the urgency of the request. Determine if the MRI should be performed as a routine or urgent study. Clearly indicate if there is a need for expedited reporting or if it is critical to complete the study promptly.
7. Provide any relevant co-existing medical conditions or contraindications that the imaging team should be aware of, such as allergies, previous surgeries, or claustrophobia. This information will help optimize patient care and ensure their safety during the procedure.
8. Remember to sign and date the request. This verifies that the request has been made by an authorized healthcare professional. Include your name, title, and contact information in case there is a need for further clarification regarding the request.

Who needs an ARI Podiatric MRI request?

1. Podiatrists: Podiatrists may need to request an ARI Podiatric MRI to assist in diagnosing and managing various foot and ankle conditions. This imaging modality helps to provide valuable insights into bone, joint, ligament, and soft tissue abnormalities.
2. Orthopedic Surgeons: Orthopedic surgeons specializing in foot and ankle surgeries may require an ARI Podiatric MRI to assist in preoperative planning or to evaluate postoperative complications.
3. Sports Medicine Physicians: Sports medicine physicians who treat athletes with foot and ankle injuries may need an ARI Podiatric MRI to aid in the diagnosis and management of sports-related conditions.
4. Primary Care Physicians: Primary care physicians encountering patients with complex foot and ankle complaints may request an ARI Podiatric MRI to obtain a more accurate diagnosis and guide further treatment options.
5. Rheumatologists: Rheumatologists specializing in the assessment of inflammatory joint diseases affecting the feet and ankles may utilize an ARI Podiatric MRI to evaluate disease activity and detect associated structural abnormalities.
6. Physical Therapists: Physical therapists may request an ARI Podiatric MRI to better understand the underlying pathology affecting their patients and develop appropriate rehabilitation protocols.

Overall, anyone involved in the diagnosis, management, or treatment of foot and ankle conditions may need an ARI Podiatric MRI to obtain detailed imaging information and aid in patient care.

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