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Pulmonary Function Order Form 25 Jacobs Gulch, Kellogg, Idaho, 83837 * 2087841221Version No.: 3FAX 2087868400Shoshone Medical CenterCardiopulmonary Services Patient's Name: DOB: Phone: *STUDIES REQUESTED

How to fill out pulmonary function order form

How to fill out pulmonary function order form

1. To fill out a pulmonary function order form, follow these steps:
2. Start by entering the patient's personal information, including their full name, date of birth, and contact details.
3. Specify the referring physician's information, including their name, address, and contact details.
4. Provide the reason for the pulmonary function test order. This could be a suspected respiratory condition, pre-operative evaluation, or monitoring of a known lung disease.
5. Indicate any specific instructions for the test, such as the need for bronchodilator administration or exercise testing.
6. Choose the type of pulmonary function test required, such as spirometry, bronchial provocation test, lung volume measurement, or diffusion capacity test.
7. If necessary, provide additional information or requests in the designated space on the form.
8. Review the completed form for accuracy and completeness.
9. Finally, sign and date the form to validate the order.
10. Remember to consult the specific form provided by your institution or healthcare facility, as the layout and required information might vary.

Who needs pulmonary function order form?

1. Pulmonary function order forms are needed by healthcare professionals, typically referring physicians, who want to request a pulmonary function test for their patients.
2. These forms are used in hospitals, clinics, and diagnostic centers where pulmonary function testing is available.
3. Patients with suspected or known respiratory conditions, individuals undergoing pre-operative evaluations, or those requiring monitoring for lung diseases may be referred for pulmonary function testing.
4. The order form facilitates communication between the referring physician and the pulmonary function laboratory, ensuring the appropriate tests are performed and necessary instructions are given.

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What is pulmonary function order form?

The pulmonary function order form is a medical document used to request pulmonary function tests, which assess lung capacity and function.

Who is required to file pulmonary function order form?

Healthcare providers, including physicians and specialists, are required to file the pulmonary function order form to initiate testing for patients.

How to fill out pulmonary function order form?

To fill out the pulmonary function order form, healthcare providers should enter patient demographics, specify the tests required, provide clinical indications, and include their signature.

What is the purpose of pulmonary function order form?

The purpose of the pulmonary function order form is to standardize the request for pulmonary function testing, ensuring that healthcare providers communicate necessary information for patient care.

What information must be reported on pulmonary function order form?

The information that must be reported includes patient information, physician details, types of tests requested, clinical indications, and diagnosis codes.