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Get the free IRMER Appendix 1 Imaging Request Form v1.3 04-2018

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Imaging Referral Form Heartlands, Good Hope, Solidly Hospitals, Community Services & Chest Clinic Patient DetailsPlease write clearly and complete in BLACK ink PID NHS No Surname. Address Forename
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How to fill out irmer appendix 1 imaging

01
To fill out IRMER Appendix 1 for imaging, follow these steps:
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Begin by providing your personal details, such as your full name, date of birth, and contact information.
03
Include information about the referring clinician or practitioner, including their name, professional title, and contact details.
04
Specify the clinical indication for the imaging procedure, detailing the reason for requesting the imaging and any relevant medical history.
05
Provide details about the imaging technique being requested, including the modality (e.g., X-ray, MRI, CT scan) and any specific imaging requirements.
06
Indicate the proposed imaging location, ensuring that the appropriate facilities and equipment are available for the requested procedure.
07
Include information about the patient's radiation dose history, if applicable, to ensure appropriate consideration of cumulative dose exposure.
08
Specify any special requirements or considerations for the imaging procedure, such as the patient's ability to cooperate or any sedation requirements.
09
Ensure all relevant sections of the Appendix 1 form are completed accurately and legibly.
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Review the completed form for any errors or missing information before submitting it for further processing.
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Retain a copy of the completed IRMER Appendix 1 form for your records.

Who needs irmer appendix 1 imaging?

01
IRMER Appendix 1 imaging is required for individuals who are requesting medical imaging procedures that involve the use of ionizing radiation. This may include:
02
- Patients referred by healthcare professionals for diagnostic imaging, such as X-rays, CT scans, or nuclear medicine procedures.
03
- Individuals undergoing radiation therapy or other treatment involving the use of ionizing radiation.
04
- Healthcare professionals involved in radiology services or the interpretation of medical images, who may be required to justify the use of ionizing radiation.
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IRMER Appendix 1 Imaging refers to the documentation and reporting requirements under the Ionising Radiation (Medical Exposure) Regulations (IRMER) related to medical imaging practices.
Radiology departments and other healthcare providers that utilize ionising radiation for medical imaging are required to file IRMER Appendix 1 Imaging.
To fill out IRMER Appendix 1 Imaging, collect data regarding the types of imaging procedures performed, the number of patients, and ensure compliance with relevant safety and quality standards before completing the form.
The purpose of IRMER Appendix 1 Imaging is to ensure the safe and effective use of ionising radiation in medical imaging and to maintain accurate records for regulatory compliance.
Information that must be reported includes the types of imaging modalities used, the number of exposures, patient demographics, and adherence to dose limits.
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