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IMAGING REQUEST Part 1Department of RadiologyPlease complete and fax to the appropriate scheduler (see fax information at lower left.) For telephone assistance: (603)6504488This is Part 1 of 2 pages,
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Keck Medicine of USC is the medical enterprise of the University of Southern California, comprising the Keck School of Medicine and various hospitals and clinics. It focuses on patient care, research, education, and community service.
Individuals who are patients receiving care or services at Keck Medicine of USC may be required to provide personal and insurance information, as well as any necessary documentation for medical coverage.
To fill out documents for Keck Medicine of USC, patients typically need to complete required forms during their initial visit, which may include personal details, medical history, and insurance information.
The purpose of Keck Medicine of USC is to provide high-quality medical care, conduct advanced research, and train future healthcare professionals, thereby improving health outcomes and community health.
Information that must be reported includes personal identification details, medical history, insurance information, and any relevant health disclosures to ensure appropriate medical care.
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