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PET/CT SCAN REQUISITION AND ELIGIBILITY CHECKLIST Principal Investigator: Dr. Francis Board (BC Cancer Agency)Protocol # H1601551Study Title: 18FDCFPyL Positron Emission Tomography / Computed Tomography
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How to fill out petct scan requisition and
How to fill out petct scan requisition and
01
Fill out patient's personal information including full name, date of birth, and contact information.
02
Specify the reason for the PET/CT scan and provide any relevant medical history.
03
Indicate any specific preparation instructions such as fasting or medication changes.
04
Include any previous imaging studies or reports that may be relevant to the scan.
05
Submit the requisition form to the imaging facility or healthcare provider for processing.
Who needs petct scan requisition and?
01
Individuals who have been recommended a PET/CT scan by their healthcare provider.
02
Patients who are undergoing cancer treatment or monitoring for cancer recurrence.
03
Individuals with certain underlying medical conditions that can be assessed through PET/CT imaging.
04
Patients participating in clinical research studies that require PET/CT scans for evaluation.
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What is petct scan requisition and?
PetCT scan requisition is a form that is filled out by a healthcare provider to request a Positron Emission Tomography - Computed Tomography scan for a patient.
Who is required to file petct scan requisition and?
A healthcare provider such as a physician or a radiologist is required to file the PetCT scan requisition form.
How to fill out petct scan requisition and?
The PetCT scan requisition form should be filled out by providing patient information, reason for the scan, and any other relevant details.
What is the purpose of petct scan requisition and?
The purpose of the PetCT scan requisition is to request a specific type of imaging scan for diagnostic or treatment purposes.
What information must be reported on petct scan requisition and?
The PetCT scan requisition should include patient details, reason for the scan, relevant medical history, and any specific instructions.
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