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Physician Order Form for Nuclear Medicine Imaging To schedule, FAX completed form to: 5034942879 Voice contact: 5034948468 Required information is indicated in BOLD, this request will be returned
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How to fill out pet-ct-order-form-new-ohsu 003 002
How to fill out pet-ct-order-form-new-ohsu 003 002
01
Start by opening the pet-ct-order-form-new-ohsu 003 002 document.
02
Fill in the patient's personal information such as name, date of birth, and contact details.
03
Provide the relevant medical history of the patient, including any known allergies or previous surgeries.
04
Indicate the reason for ordering the PET-CT scan and any specific areas of interest.
05
Specify the type of scan required, such as whole-body or specific region.
06
Include any additional instructions or requests for the radiologist.
07
Fill in the referring physician's information and contact details.
08
Ensure all required fields are completed and review the form for accuracy.
09
Submit the filled-out form to the appropriate department or hospital.
Who needs pet-ct-order-form-new-ohsu 003 002?
01
The pet-ct-order-form-new-ohsu 003 002 is needed by healthcare professionals, such as referring physicians or specialists, who want to order a PET-CT scan for their patients.
02
The form helps in providing necessary information about the patient, their medical history, reason for the scan, and any specific instructions for the radiologist.
03
This form ensures proper communication between the referring physician and the radiology department, enabling them to perform the scan accurately and effectively.
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What is pet-ct-order-form-new-ohsu 003 002?
pet-ct-order-form-new-ohsu 003 002 is a form used to order a PET-CT scan at OHSU.
Who is required to file pet-ct-order-form-new-ohsu 003 002?
Medical professionals or healthcare providers are required to file the pet-ct-order-form-new-ohsu 003 002 for patients.
How to fill out pet-ct-order-form-new-ohsu 003 002?
To fill out the form, the medical professional needs to provide patient information, reason for the PET-CT scan, and any other relevant details.
What is the purpose of pet-ct-order-form-new-ohsu 003 002?
The purpose of the form is to request a PET-CT scan for diagnostic or treatment purposes.
What information must be reported on pet-ct-order-form-new-ohsu 003 002?
The form must include patient demographics, medical history, reason for the scan, relevant clinical information, and ordering physician details.
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