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Legacy Health Cardiopulmonary Physician Referral Form Check one location for your referralContact Imaging scheduling to schedule a cardiac nuclear stress Phone: 5034137800 Fax: 5034138899 For USMC

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How to fill out 5034137800 form

How to fill out legacy imagingmount hood medical

01

Gather all necessary information and documents required to fill out legacy imaging form.

02

Visit the Mount Hood Medical center or their website to access the form.

03

Carefully read and follow the instructions provided on the form.

04

Fill out all the required fields accurately and completely.

05

Double-check the information filled in the form for any errors or omissions.

06

Submit the completed form to the designated recipient or office.

Who needs legacy imagingmount hood medical?

01

Anyone who is seeking medical imaging services at the Mount Hood Medical center may need to fill out the legacy imaging form.

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What is legacy imagingmount hood medical?

Legacy imagingmount hood medical is a form used for reporting medical imaging services provided by Legacy Health Imaging at Mount Hood Medical Center.

Who is required to file legacy imagingmount hood medical?

Healthcare providers who have performed medical imaging services at Legacy Health Imaging at Mount Hood Medical Center are required to file legacy imagingmount hood medical.

How to fill out legacy imagingmount hood medical?

Legacy imagingmount hood medical can be filled out by providing the necessary information about the medical imaging services provided, including the patient's information, date of service, type of service, and other relevant details.

What is the purpose of legacy imagingmount hood medical?

The purpose of legacy imagingmount hood medical is to report accurate information about medical imaging services provided at Legacy Health Imaging at Mount Hood Medical Center for billing and administrative purposes.

What information must be reported on legacy imagingmount hood medical?

Information such as patient's name, date of service, type of imaging service provided, referring physician, and other relevant details must be reported on legacy imagingmount hood medical.

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