UK PET/CT Scan Referral Form 2007-2025 free printable template

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How to fill out scan referral form

How to fill out a CT scan referral form:

1. Begin by entering your personal information, such as your name, date of birth, and contact details.
2. Provide your medical history, including any relevant conditions, medications, or allergies. This will help the healthcare provider make an informed decision regarding your CT scan.
3. Indicate the reason for the referral, specifying any symptoms or concerns that led to the decision for a CT scan.
4. Include any previous imaging or test results that may be relevant for the CT scan. This can help the radiologist compare the new images with any existing ones.
5. If applicable, specify the body part or area of interest for the scan. This is crucial for the radiologist to focus on the relevant region and provide accurate results.
6. If you have any specific instructions or preferences for the scan, such as the use of contrast agents or sedation, make sure to include them in the referral form.
7. If necessary, provide any additional information requested by the healthcare provider or the imaging facility.
8. Review the completed form for accuracy and completeness before submitting it to the appropriate healthcare professional or facility.

Who needs a CT scan referral form?

1. Patients who require a CT scan to further investigate their medical condition.
2. Individuals who have experienced specific symptoms or abnormalities that warrant imaging.
3. Patients who are being referred by their primary care physician or specialist for further evaluation, diagnosis, or treatment planning.

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What is UK PETCT Scan Referral Form?

The UK PETCT Scan Referral Form is a document used by healthcare professionals to refer patients for a Positron Emission Tomography-Computed Tomography (PET-CT) scan, which is an imaging technique that helps in diagnosing and monitoring various health conditions.

Who is required to file UK PETCT Scan Referral Form?

Healthcare professionals such as doctors, specialists, or authorized practitioners who believe a patient requires a PET-CT scan for diagnostic purposes are required to file the UK PETCT Scan Referral Form.

How to fill out UK PETCT Scan Referral Form?

To fill out the UK PETCT Scan Referral Form, the referring healthcare professional must provide patient details, clinical information, reason for the referral, and any relevant medical history, ensuring all sections of the form are accurately completed.

What is the purpose of UK PETCT Scan Referral Form?

The purpose of the UK PETCT Scan Referral Form is to ensure that patients are appropriately evaluated for a PET-CT scan, facilitating timely and accurate imaging to assist in diagnosis, treatment planning, and monitoring of diseases.

What information must be reported on UK PETCT Scan Referral Form?

The UK PETCT Scan Referral Form must report information such as patient demographics (name, date of birth, NHS number), referring physician details, clinical indication for the scan, relevant medical history, and any previous imaging results related to the condition being assessed.