Get the free X-Ray X-Ray Requisition - Providence Health Care

X-Ray Requisition SURNAME MR MISS MRS MS PERMANENT ADDRESS POSTAL CODE CELL PHONE FIRST NAME HOME PHONE WORK PHONE ST. PAUL S HOSPITAL 1081 Bernard St., Vancouver, BC V6Z 1Y6 Phone: 604-806-8006 Fax:

How to fill out x-ray x-ray requisition

How to fill out an x-ray requisition:

1. Begin by providing your personal information, including your full name, date of birth, gender, and contact information. This information is crucial for identifying the patient and delivering the results.
2. Specify the reason for the x-ray by indicating the body part or system that needs to be examined. This helps the healthcare provider understand the purpose of the x-ray and ensures accurate imaging.
3. Include any relevant medical history, particularly if you have undergone previous imaging tests or surgeries related to the area being examined. This information assists the radiologist in interpreting the x-ray results.
4. If you have any allergies or are currently taking medications, mention them on the requisition form. This data helps the healthcare team ensure your safety during the x-ray procedure.
5. Provide the name and contact information of your referring physician. This ensures that the results are sent to the appropriate healthcare provider who ordered the x-ray.
6. Finally, sign and date the requisition form to acknowledge that the information provided is accurate and complete. This acts as your consent for the x-ray procedure.

Who needs an x-ray requisition?

1. Patients with suspected fractures or injuries: X-ray requisitions are commonly used when patients present with symptoms or signs that indicate a possible bone fracture or injury. The requisition helps guide radiologists in capturing the necessary images to confirm or rule out these conditions.
2. Individuals with suspected diseases or abnormalities: X-ray requisitions are also necessary when investigating suspected diseases or abnormalities in various body parts or systems. For example, a requisition may be required to examine the chest for signs of pneumonia or detect lung tumors.
3. Pre-operative and post-operative patients: Surgeons often request x-ray requisitions before a surgical procedure to assess the affected area's condition. Following surgery, requisitions may be needed to monitor healing progress or detect any complications that may arise.
4. Routine check-ups or screenings: Some individuals may undergo routine x-rays as part of regular health check-ups or preventive screenings. In such cases, the requisition serves as a guide for the radiologist to capture the appropriate images.

By accurately filling out the x-ray requisition and ensuring that it is given to the healthcare provider, you are enabling the necessary imaging tests to be performed, aiding in diagnosis and appropriate treatment.

For pdfFiller’s FAQs

How do I edit x-ray x-ray requisition in Chrome?

Adding the pdfFiller Google Chrome Extension to your web browser will allow you to start editing x-ray x-ray requisition and other documents right away when you search for them on a Google page. People who use Chrome can use the service to make changes to their files while they are on the Chrome browser. pdfFiller lets you make fillable documents and make changes to existing PDFs from any internet-connected device.

How do I edit x-ray x-ray requisition straight from my smartphone?

You may do so effortlessly with pdfFiller's iOS and Android apps, which are available in the Apple Store and Google Play Store, respectively. You may also obtain the program from our website: https://edit-pdf-ios-android.pdffiller.com/. Open the application, sign in, and begin editing x-ray x-ray requisition right away.

How do I fill out x-ray x-ray requisition on an Android device?

On an Android device, use the pdfFiller mobile app to finish your x-ray x-ray requisition. The program allows you to execute all necessary document management operations, such as adding, editing, and removing text, signing, annotating, and more. You only need a smartphone and an internet connection.

What is x-ray x-ray requisition?

X-ray requisition is a form that requests for a patient to undergo an x-ray imaging procedure.

Who is required to file x-ray x-ray requisition?

X-ray requisition can be filed by a referring physician or a healthcare provider.

How to fill out x-ray x-ray requisition?

X-ray requisition should be filled out with the patient's information, reason for the x-ray, and any other relevant details.

What is the purpose of x-ray x-ray requisition?

The purpose of x-ray requisition is to authorize and provide necessary information for a patient to undergo an x-ray imaging procedure.

What information must be reported on x-ray x-ray requisition?

Information such as patient's name, date of birth, reason for x-ray, referring physician's details, and any relevant medical history must be reported on x-ray requisition.