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Peterborough Regional Health Center Diagnostic Imaging Services C.T. REQUISITION Outpatient Booking: Fax 7058765046 Inpatient Booking : Fax 7058765127 Inpatient Outpatient Wheelchair Ambulatory Non-Ambulatory
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01
Begin by opening the MRI Appointments Requisition Forms-10b.pdf on your computer or device.
02
Fill in the patient's personal information such as name, address, date of birth, and contact details in the designated fields.
03
Provide the referring physician's information, including their name, address, and contact details.
04
Enter the patient's medical history, including any relevant conditions or medications, in the specified section.
05
Indicate the type of MRI examination required by checking the appropriate box or writing it down if there is no option provided.
06
If there are any specific instructions or additional information necessary for the appointment, include them in the provided space.
07
Review the filled-out form to ensure all the information is accurate and complete.
08
Save a copy of the filled-out form on your device for your records.
09
Print the form if required, and submit it to the relevant department or healthcare provider as instructed.
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The MRI Appointments Requisition Forms-10b.pdf is needed by healthcare providers, referring physicians, or medical personnel who require a patient to undergo an MRI examination.
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mriappointments-requisition-forms-10bpdf is a required documentation form related to MRI appointment requests, detailing patient information and medical necessity.
Healthcare providers or professionals requesting MRI appointments on behalf of their patients are required to file the mriappointments-requisition-forms-10bpdf.
To fill out the mriappointments-requisition-forms-10bpdf, provide accurate patient information, medical history, and the specifics of the MRI requested, ensuring all fields are completed as per the guidelines.
The purpose of mriappointments-requisition-forms-10bpdf is to facilitate the scheduling of MRI appointments by providing necessary patient and medical information to the imaging facility.
The information that must be reported on mriappointments-requisition-forms-10bpdf includes patient demographics, referring physician details, medical reasons for the MRI, and any relevant prior medical history.
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