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Request for Patient InformationHumber River Hospital 1235 Wilson Ave. LEVEL 2 EAST Toronto, ON M3M 0B2 Phone 4162421000 Ext. 63500 Fax 18559321257DOB (d/m/y) ___ Sex MF Appointment InformationAddress

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How to fill out request for interventional radiology

01

Obtain the necessary patient information such as name, date of birth, and medical history.

02

Clearly indicate the reason for the request for interventional radiology, including any relevant symptoms or findings.

03

Specify the type of procedure or intervention needed, if known.

04

Include any relevant imaging studies or test results that support the need for the procedure.

05

Provide contact information for the referring physician in case further clarification is needed.

Who needs request for interventional radiology?

01

Patients who have been diagnosed with a condition that may benefit from an interventional radiology procedure.

02

Physicians who believe that an interventional radiology procedure may be a suitable treatment option for their patient.

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What is request for interventional radiology?

A request for interventional radiology is a formal document that is submitted to medical professionals in order to request a specific interventional radiology procedure.

Who is required to file request for interventional radiology?

The request for interventional radiology can be filed by a referring physician, a healthcare provider, or a patient themselves, depending on the specific situation.

How to fill out request for interventional radiology?

To fill out a request for interventional radiology, one must provide relevant patient information, details of the procedure being requested, and any supporting medical documentation.

What is the purpose of request for interventional radiology?

The purpose of a request for interventional radiology is to communicate the need for a specific interventional radiology procedure and to ensure that the procedure is performed in a timely and appropriate manner.

What information must be reported on request for interventional radiology?

Information such as patient demographics, medical history, specific procedure requested, and any relevant imaging studies or test results must be included on a request for interventional radiology.

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