Get the free secure radiology transmittal form - nwhealth

Radiology Transmittal Form Radiological Consultation Services 2501 W. 84th St. Bloomington, MN 55431-1599 Phone: (952) 885-5464 Fax: (952) 886-7565 Website: www.nwhealth.edu/rcs Professional questions

How to fill out secure radiology transmittal form

How to fill out secure radiology transmittal form:

1. Start by gathering all necessary information such as patient's name, date of birth, and medical record number.
2. Fill in the referring physician's information, including their name, contact details, and any relevant identification numbers.
3. Clearly indicate the type of imaging study being requested, such as MRI, CT scan, or X-ray.
4. Specify the reason for the study, whether it is for diagnosis, follow-up, or screening purposes.
5. Provide any additional clinical information that may be relevant for the radiologist, such as specific symptoms or suspected conditions.
6. Enter the requested date and time for the imaging study, keeping in mind any urgency or preferred scheduling requested by the referring physician.
7. Make sure to include any necessary attachments, such as previous imaging reports or relevant medical documents that are required for the radiologist's evaluation.
8. Double-check all the entered information for accuracy and completeness before submitting the form.

Who needs secure radiology transmittal form:

1. Patients who are referred to a radiology department by their healthcare provider for diagnostic imaging.
2. Healthcare providers such as physicians, specialists, or dentists who are requesting imaging studies for their patients.
3. Radiology departments or facilities that require a standardized and secure form to gather all necessary information for scheduling and evaluating imaging studies.

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What is secure radiology transmittal form?

Secure radiology transmittal form is a document used to securely transmit radiology images and reports between facilities.

Who is required to file secure radiology transmittal form?

Healthcare facilities and providers who send or receive radiology images and reports are required to file secure radiology transmittal form.

How to fill out secure radiology transmittal form?

To fill out secure radiology transmittal form, you need to provide information about the sending and receiving facilities, patient information, description of the radiology images or reports being transmitted, and any necessary authorization or consent forms.

What is the purpose of secure radiology transmittal form?

The purpose of secure radiology transmittal form is to ensure the secure and accurate transmission of radiology images and reports between healthcare facilities.

What information must be reported on secure radiology transmittal form?

Secure radiology transmittal form typically requires information such as sending and receiving facility details, patient information, type of radiology images or reports being transmitted, and any necessary authorization or consent forms.