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Health Record #: Complete or place barcoded patient label here Patient Name: (Print first, last) dd mm by DOB: / / 596 Davis Drive Newmarket, ON L3Y 2P9Age: q Females Malachi #: Version Code: dd mm
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Diagnostic imaging - fax is a method of transmitting medical images electronically using a fax machine for diagnostic purposes.
Medical facilities and healthcare providers are required to file diagnostic imaging - fax when transmitting medical images.
To fill out diagnostic imaging - fax, the sender must include patient information, type of imaging study, date of study, and reason for transmission.
The purpose of diagnostic imaging - fax is to quickly transmit medical images for timely diagnosis and treatment.
Information such as patient name, medical record number, type of imaging study, date of study, and reason for transmission must be reported on diagnostic imaging - fax.
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