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Mallinckrodt Institute of Radiology Barnes Jew is Hospital Physician Request Form for Oncologic FIDGET/CT Imaging Patient Name DOB Social Security No. Patients Address City, State, Zip Physician Type
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How to fill out referring a patient for

01
Obtain the patient's complete information and medical history.
02
Identify the specialist or healthcare provider to whom the patient needs to be referred.
03
Ensure that the referral form is properly filled out with all necessary details, such as reason for referral, patient's current medications, and any relevant test results.
04
Submit the referral form to the specialist or healthcare provider's office either electronically or by fax.
05
Follow up with the specialist's office to confirm that the referral has been received and to schedule an appointment for the patient.

Who needs referring a patient for?

01
Patients who require specialized care or treatment beyond the scope of the referring healthcare provider.
02
Patients who need to be seen by a specialist for a particular medical condition or issue.
03
Patients who can benefit from the expertise and resources of a healthcare provider with specific knowledge or skills in a particular area of medicine.
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Referring a patient is the process of directing a patient to another healthcare provider for specialized care or services.
Healthcare professionals such as physicians, nurse practitioners, and specialists who make referrals are required to file referring a patient.
To fill out a referral form, provide patient information, the reason for the referral, relevant medical history, and the referring healthcare provider's contact details.
The purpose of referring a patient is to ensure that they receive appropriate diagnostic, therapeutic, or specialized care that is outside the scope of the referring provider's practice.
The information that must be reported includes patient demographics, insurance details, referral reasons, relevant clinical information, and provider details.
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