Get the free SWEDISH EDMONDS IMAGING REQUISITION FORM

SWEDISH MEDICAL IMAGING SWEDISH EDMONDS IMAGING REQUISITION FORM Today's date: Phone: 4256404260 Fax: 4256404472 21601 76th Ave. W., Edmonds, WA 98026Patient information: (All fields are required)

How to fill out swedish edmonds imaging requisition

How to fill out swedish edmonds imaging requisition

1. Obtain a copy of the Swedish Edmonds Imaging Requisition form from the appropriate healthcare provider or facility.
2. Begin by filling out the patient information section on the form. Provide the patient's full name, date of birth, address, and contact information.
3. In the clinical information section, indicate the reason for the imaging request and any relevant medical history or symptoms.
4. Specify the type of imaging study that is required, such as an X-ray, MRI, CT scan, or ultrasound.
5. If there are any specific instructions for the imaging procedure, such as fasting or medication restrictions, make sure to note them in the appropriate field.
6. Fill in the ordering physician's information, including their name, contact details, and any required provider credentials.
7. If applicable, include the referring physician's information as well, including their name and contact details.
8. Review the completed form for accuracy and completeness, ensuring that all necessary sections have been filled out properly.
9. Submit the filled-out Swedish Edmonds Imaging Requisition form to the designated imaging center or healthcare facility either in person, by mail, or through electronic submission.
10. Keep a copy of the requisition form for your records.

Who needs swedish edmonds imaging requisition?

1. Patients who require imaging studies at Swedish Edmonds or healthcare providers who are ordering these imaging tests.

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What is swedish edmonds imaging requisition?

Swedish Edmonds Imaging Requisition is a form used to request imaging services at Swedish Edmonds Hospital.

Who is required to file Swedish Edmonds Imaging Requisition?

Healthcare providers, physicians, or authorized medical personnel are required to file Swedish Edmonds Imaging Requisition.

How to fill out Swedish Edmonds Imaging Requisition?

Swedish Edmonds Imaging Requisition can be filled out by providing patient information, reason for imaging request, and specific imaging requirements.

What is the purpose of Swedish Edmonds Imaging Requisition?

The purpose of Swedish Edmonds Imaging Requisition is to facilitate the request and scheduling of imaging services for patients.

What information must be reported on Swedish Edmonds Imaging Requisition?

Patient demographics, medical history, reason for imaging request, and any specific imaging protocols must be reported on Swedish Edmonds Imaging Requisition.