Get the free PET Imaging Request Form - The Alfred Hospital
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Alfred Hospital Nuclear Medicine Department First Floor East Block, Commercial Rd Melbourne VIC Australia 3004Enquiries & Appointments PHONE: +61 3 9076 2432 Submit a referral FAX: +61 3 9076 2599
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How to fill out pet imaging request form
How to fill out pet imaging request form
01
Step 1: Start by filling out the patient's personal information, such as their full name, date of birth, and contact details.
02
Step 2: Specify the reason for the PET imaging request. Include details about the suspected medical condition or the purpose of the scan.
03
Step 3: Indicate any previous medical history that may be relevant to the imaging procedure, such as previous surgeries, allergies, or current medications.
04
Step 4: Provide information about the referring physician, including their name, contact information, and any specific requirements they have for the imaging procedure.
05
Step 5: Include any additional instructions or special considerations for the PET imaging request, such as fasting requirements, contrast agent usage, or any specific imaging protocols.
06
Step 6: Once you have completed filling out the form, review the information for accuracy and completeness before submitting it.
Who needs pet imaging request form?
01
PET imaging request form is typically needed by medical professionals, such as physicians, radiologists, or referring specialists, who require a PET scan for diagnostic purposes.
02
It is also required by medical institutions or imaging centers where the PET scan will be performed to ensure proper documentation and workflow.
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What is pet imaging request form?
The PET imaging request form is a document used to request a positron emission tomography (PET) scan.
Who is required to file pet imaging request form?
Pet imaging request forms are typically filed by medical professionals such as physicians or radiologists.
How to fill out pet imaging request form?
The form must be filled out with patient information, reason for the PET scan, and any other relevant medical history.
What is the purpose of pet imaging request form?
The purpose of the form is to request a PET scan for diagnostic or monitoring purposes.
What information must be reported on pet imaging request form?
The form must include patient demographics, clinical indications for the scan, and any relevant prior imaging studies.
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