Get the free PEDIATRIC/CONGENITAL CARDIAC MRI REQUEST FORM - medicine duke

PEDIATRIC/CONGENITAL CARDIAC MRI REQUEST FORM FOR INTERNAL USE ONLYPlease FAX to (919) 6685588 Schedule at (919) 6685580Scan Date: Scan Time:Date of Request: ___Scanner Location: Patient Info Sent?NSYNPatient

How to fill out pediatriccongenital cardiac mri request

How to fill out pediatriccongenital cardiac mri request

1. Obtain a pediatriccongenital cardiac MRI request form from the appropriate medical facility or department.
2. Fill out the patient's personal information, including their name, date of birth, and contact information.
3. Specify the reason for the pediatriccongenital cardiac MRI request, providing a brief explanation of the medical condition or symptoms.
4. Indicate any relevant medical history or previous cardiac imaging results that may assist the healthcare provider in interpreting the MRI.
5. Include the name and contact information of the referring physician or healthcare provider.
6. Ensure that all sections of the request form are completed accurately and legibly.
7. Submit the completed pediatriccongenital cardiac MRI request form to the appropriate medical facility or department for processing.
8. Follow any additional instructions provided by the healthcare provider or facility regarding preparation or scheduling of the MRI.

Who needs pediatriccongenital cardiac mri request?

1. Individuals who require pediatriccongenital cardiac MRI are typically those with congenital heart defects or suspected abnormalities in the structure or function of the heart.
2. This may include infants, children, or adolescents who are experiencing symptoms such as heart murmurs, chest pain, or unexplained shortness of breath.
3. Pediatriccongenital cardiac MRI can provide detailed imaging information that helps diagnose and evaluate the severity of heart conditions in this patient population.
4. It is often requested by pediatric cardiologists, pediatric cardiothoracic surgeons, or other specialists involved in the care of pediatric patients with cardiac concerns.

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What is pediatric congenital cardiac mri request?

Pediatric congenital cardiac MRI request is a medical imaging procedure requested by healthcare providers to diagnose and evaluate congenital heart conditions in children.

Who is required to file pediatric congenital cardiac mri request?

Healthcare providers such as pediatric cardiologists, pediatricians, or referring physicians are required to file pediatric congenital cardiac MRI requests.

How to fill out pediatric congenital cardiac mri request?

To fill out a pediatric congenital cardiac MRI request, healthcare providers need to include patient information, clinical history, reason for the request, and any relevant medical records.

What is the purpose of pediatric congenital cardiac mri request?

The purpose of pediatric congenital cardiac MRI request is to assess and monitor congenital heart defects in children, guide treatment decisions, and evaluate the effectiveness of interventions.

What information must be reported on pediatric congenital cardiac mri request?

Information reported on a pediatric congenital cardiac MRI request includes patient demographics, clinical indications, relevant medical history, and any specific imaging requirements.