Get the free DIAGNOSTIC IMAGING REQUEST FORM - kingedwardvii.co.uk

KING Edward\'s HOSPITALDIAGNOSTIC IMAGING REQUEST FORM Imaging Department, Beaumont Street, London WLG 6AA T: 020 7467 4317 F: 020 7467 4395 E: imaging secretary×kingedwardvii.co.UK W: www.kingedwardvii.co.ukPatient\'s

How to fill out diagnostic imaging request form

How to fill out diagnostic imaging request form

1. Start by obtaining the diagnostic imaging request form from the relevant healthcare facility or provider.
2. Read the instructions and guidelines provided on the form carefully to understand what information needs to be filled out.
3. Begin by entering your personal information such as your name, date of birth, contact details, and any relevant identification numbers.
4. Fill in the details of the referring healthcare provider, including their name, contact information, and any necessary identification numbers.
5. Specify the type of diagnostic imaging test or procedure being requested, such as an X-ray, MRI, CT scan, or ultrasound.
6. Provide a detailed and accurate description of the reason for the imaging request, including any relevant symptoms, medical history, or suspected conditions.
7. If applicable, indicate any specific areas or regions of the body that need to be focused on during the imaging examination.
8. Include any previous relevant imaging studies or test results that may aid in the interpretation of the new imaging exam.
9. Sign and date the form to confirm your consent for the diagnostic imaging test and to acknowledge the accuracy of the information provided.
10. Submit the completed form to the healthcare facility or provider through the designated channels, such as in person, by mail, or electronically.
11. Keep a copy of the completed form for your records and reference.

Who needs diagnostic imaging request form?

1. Anyone who requires diagnostic imaging services or tests ordered by a healthcare provider needs to fill out a diagnostic imaging request form.
2. This can include individuals who are experiencing certain symptoms, undergoing medical investigations, or monitoring the progress of a particular condition.
3. The diagnostic imaging request form helps ensure that the necessary information is provided to the imaging facility or radiology department to perform the requested tests accurately and safely.

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What is diagnostic imaging request form?

The diagnostic imaging request form is a document used to request specific imaging tests or procedures for medical diagnosis.

Who is required to file diagnostic imaging request form?

Medical professionals such as doctors, radiologists, or other healthcare providers are required to file the diagnostic imaging request form.

How to fill out diagnostic imaging request form?

The form typically requires information such as patient details, type of imaging test needed, medical history, and referring physician information.

What is the purpose of diagnostic imaging request form?

The purpose of the diagnostic imaging request form is to ensure that the correct imaging tests are ordered for accurate diagnosis and treatment.

What information must be reported on diagnostic imaging request form?

Patient details, type of imaging test needed, medical history, referring physician information, and any specific instructions or concerns.