Get the free DEXA REQUEST FORM - v 6 Oct 11.doc

Dept of Endocrinology, The Christie NHS Foundation Trust, Willow Road, Manchester M20 4BX DEXA Inquiries / Endocrine Unit: Tel 0161 446 3479 New Referrals/Patients to The Christie : Fax 0161 446 3772

How to fill out dexa request form

1. To fill out a dexa request form, you will need to start by obtaining the form itself. This can typically be done by contacting the healthcare facility or doctor's office where you plan to have the Dexa scan.
2. Once you have the form in hand, carefully read through the instructions and ensure you understand all the required information. This will help you provide accurate and complete details on the form.
3. Begin by filling out your personal information, such as your name, date of birth, and contact details. Make sure to write legibly and use your full legal name as it appears on your identification.
4. The next section may require you to provide your medical history or current medications you are taking. Be honest and thorough in listing any relevant information, as it can help the healthcare provider interpret the Dexa scan results more accurately.
5. If you have any specific concerns or areas of interest you would like the Dexa scan to focus on, there may be a section to indicate this. Use this opportunity to communicate your preferences or any questions you may have.
6. Depending on the facility's requirements, you may need to provide insurance information or payment details. Double-check if there are any fees associated with the Dexa scan and ensure you complete this section accurately.
7. Finally, review the filled-out form to ensure all information is correct and complete. Take your time to check for any spelling errors or missing details before submitting the form.

Who needs a Dexa request form?

1. Individuals who suspect or have been advised by their healthcare provider to undergo a Dexa scan, commonly known as a bone density scan, will need a Dexa request form.
2. Patients who are at risk of osteoporosis, including postmenopausal women, older adults, individuals with a family history of osteoporosis, or those with certain medical conditions or medications that may affect bone health, may require a Dexa scan.
3. Healthcare professionals who specialize in diagnosing and treating osteoporosis, such as rheumatologists, endocrinologists, or orthopedic specialists, may also utilize Dexa request forms to order the scan for their patients.

In summary, to fill out a Dexa request form, obtain the form, carefully read and understand the instructions, provide accurate personal and medical information, and review the form before submitting it. The Dexa request form is needed by individuals who require a bone density scan, such as those at risk of osteoporosis, under the guidance of their healthcare provider.

For pdfFiller’s FAQs

What is dexa request form?

Dexa request form is a form used to request a dual-energy X-ray absorptiometry (DEXA) scan, which is a bone density test.

Who is required to file dexa request form?

Patients who have been prescribed a DEXA scan by their healthcare provider are required to file the DEXA request form.

How to fill out dexa request form?

To fill out the DEXA request form, patients need to provide their personal information, medical history, and pertinent details about why the DEXA scan is needed.

What is the purpose of dexa request form?

The purpose of the DEXA request form is to ensure that patients receive the necessary bone density test and that healthcare providers have all the information needed to interpret the results.

What information must be reported on dexa request form?

The DEXA request form must include the patient's name, date of birth, medical history, reason for the DEXA scan, and any relevant medication or medical conditions.

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