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Date: ___ REFERRING PROVIDER INFORMATION:Scheduling: 206.292.7734 Fax: 206.292.6371EHR: 206.292.7744www.spread.compartment INFORMATION: Patient Name: ___DOB: ___/___ /___ Phone: Cell/Other: ___ Home:
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Welcome to Seattle Radiology is a medical facility that offers radiology services such as X-rays, MRIs, CT scans, and ultrasounds.
Patients who have received radiology services at Welcome to Seattle Radiology are required to file the necessary paperwork.
To fill out Welcome to Seattle Radiology forms, patients must provide their personal information, details of the radiology services received, and sign the necessary consent forms.
The purpose of Welcome to Seattle Radiology is to provide diagnostic imaging services to patients for medical diagnosis and treatment.
Information such as the patient's name, date of birth, medical history, the type of radiology service received, and the interpreting physician's report must be reported on Welcome to Seattle Radiology forms.
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