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SPOKANE REGIONAL HEALTH DISTRICT PHONE 5093232851 FAX 5093241408 WWW.RHD.ORG DOH 345211 Jan 2016Breast Diagnostic Form CLIENT NAME (Last, First, MI)BC CHP ID#: Authorization #: SOCIAL SECURITY NUMBER

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What is breast diagnostic form?

The breast diagnostic form is a medical document used to collect information related to breast examinations and diagnostic procedures. It helps healthcare providers record findings and make informed decisions regarding further treatment or screening.

Who is required to file breast diagnostic form?

Healthcare providers and facilities that perform breast diagnostic procedures, such as mammograms, biopsies, and other imaging studies, are required to file the breast diagnostic form.

How to fill out breast diagnostic form?

To fill out the breast diagnostic form, healthcare providers should accurately document patient information, including personal details, medical history, the type of diagnostic procedure performed, findings, and recommendations for follow-up care.

What is the purpose of breast diagnostic form?

The purpose of the breast diagnostic form is to ensure standardized reporting and documentation of breast health evaluations, facilitating communication among healthcare providers and improving patient care.

What information must be reported on breast diagnostic form?

The information that must be reported includes patient demographics, clinical history, details of the diagnostic procedures performed, findings such as any abnormalities detected, and any recommended follow-up actions.

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