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Vascular Ultrasound Laboratory Referral Form 5092495735 Fax: 5092495734 info@pacificvascular.com www.pacificvascular.comRevised 03/02/2022TO BE COMPLETED BY REFERRING PROVIDER Fax this page to 5092495734
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How to fill out stagingpacificvascularcomwp-contentuploadsvascular ultrasound laboratory referral
How to fill out stagingpacificvascularcomwp-contentuploadsvascular ultrasound laboratory referral
01
Visit the website staging.pacificvascular.com/wp-content/uploads/vascular-ultrasound-laboratory-referral
02
Fill out the necessary patient information such as name, date of birth, and contact details
03
Provide details about the referring physician or healthcare provider
04
Include information about the type of ultrasound study required and reason for referral
05
Submit the form electronically or print it out and fax it to the vascular ultrasound laboratory
Who needs stagingpacificvascularcomwp-contentuploadsvascular ultrasound laboratory referral?
01
Patients who require a vascular ultrasound study as requested by their physician
02
Healthcare providers who are referring patients for vascular ultrasound testing
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What is stagingpacificvascularcomwp-contentuploadsvascular ultrasound laboratory referral?
The vascular ultrasound laboratory referral is a form used to refer patients for vascular ultrasound testing.
Who is required to file stagingpacificvascularcomwp-contentuploadsvascular ultrasound laboratory referral?
Medical professionals such as physicians and nurse practitioners are required to file the vascular ultrasound laboratory referral.
How to fill out stagingpacificvascularcomwp-contentuploadsvascular ultrasound laboratory referral?
The referral must include patient information, reason for referral, and any relevant medical history.
What is the purpose of stagingpacificvascularcomwp-contentuploadsvascular ultrasound laboratory referral?
The purpose of the referral is to request vascular ultrasound testing to diagnose and monitor vascular conditions.
What information must be reported on stagingpacificvascularcomwp-contentuploadsvascular ultrasound laboratory referral?
Patient demographics, referring provider information, reason for referral, and any relevant clinical information.
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