Get the free MR Image Transmittal Worksheet - acrin

ACRID 6690 MR Image Transmittal Worksheet Please mail or fax this com

How to fill out mr image transmittal worksheet

How to fill out MR image transmittal worksheet:

1. Start by entering the date of the transmittal in the designated space.
2. Next, provide the name of the sender or the person responsible for transmitting the MR images.
3. Include the contact information of the sender such as their phone number and email address.
4. Specify the recipient's details, including their name, department, and any relevant contact information.
5. Indicate the purpose of the MR images being transmitted, whether it is for diagnosis, research, or another specific reason.
6. Provide a brief description or summary of the MR images being sent, including the number of images and any important details about the procedure or patient.
7. If necessary, include any additional instructions or special requests for the recipient regarding the MR images.
8. Sign and date the transmittal worksheet to confirm that the information provided is accurate.
9. Keep a copy of the completed transmittal worksheet for your records.

Who needs MR image transmittal worksheet:

1. Radiologists: Radiologists may need the MR image transmittal worksheet to send MR images to other medical professionals for consultations or second opinions.
2. Referring Physicians: Physicians who refer patients for MR imaging may need the worksheet to transmit the images to specialists or other healthcare providers involved in the patient's care.
3. Researchers: Researchers conducting studies or clinical trials that involve MR imaging may need the worksheet to transmit images to their colleagues or to submit them to regulatory bodies.
4. Medical Records Department: The medical records department of a healthcare facility may require the MR image transmittal worksheet to properly document and track the transmission of images for record-keeping purposes.
5. Insurance Companies: Insurance companies may request MR images for claims processing and reimbursement purposes, and the transmittal worksheet can ensure the proper documentation and transfer of the images.

Note: The necessity of the MR image transmittal worksheet may vary depending on the specific policies and procedures of different healthcare facilities and organizations.

For pdfFiller’s FAQs

What is mr image transmittal worksheet?

The MR image transmittal worksheet is a document used to send magnetic resonance (MR) images to the appropriate recipient.

Who is required to file mr image transmittal worksheet?

Healthcare providers, imaging centers, and other facilities that perform MR imaging are required to file the MR image transmittal worksheet.

How to fill out mr image transmittal worksheet?

The MR image transmittal worksheet must be filled out with all relevant information about the MR images being transmitted, including patient information, date of imaging, and the recipient's information.

What is the purpose of mr image transmittal worksheet?

The purpose of the MR image transmittal worksheet is to ensure that MR images are properly transmitted to the correct recipient and that all necessary information is included.

What information must be reported on mr image transmittal worksheet?

The MR image transmittal worksheet must include patient name, date of birth, date of imaging, MR image details, and recipient information.

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