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Modified Barium Swallow Study (MASS) A MASS is a ray test for swallowing. It shows if you have problems swallowing. Food gets stuck You feel strangled Food goes down the wrong bayou will eat different

How to fill out form modified barium swallow

How to fill out form modified barium swallow

1. To fill out a form for a modified barium swallow, follow these steps:
2. Gather the necessary information: This may include the patient's personal details, medical history, and relevant medications.
3. Start with the patient's personal information: Fill in their name, age, gender, and contact information.
4. Provide medical history: Include any previous relevant medical conditions or surgeries.
5. List current medications: Include all medications the patient is currently taking.
6. Specify any allergies: Note if the patient has any known allergies to medications or substances.
7. Indicate any relevant symptoms: Document any swallowing difficulties or other symptoms experienced by the patient.
8. Include any additional information: If there are any specific concerns or requests related to the modified barium swallow, mention them here.
9. Review and double-check: Ensure all information is accurate and complete before submitting the form.
10. Submit the form: Once filled out, submit the form to the appropriate healthcare provider or facility.

Who needs form modified barium swallow?

1. A modified barium swallow may be required by individuals who are experiencing swallowing difficulties or have been diagnosed with certain medical conditions, including but not limited to:
2. - Stroke patients
3. - Patients with neurological disorders
4. - Individuals with esophageal or swallowing disorders
5. - People with a history of aspiration pneumonia
6. - Patients with head and neck cancer
7. - Individuals who have undergone certain types of surgeries or procedures that may affect swallowing
8. - Anyone who is experiencing persistent or unexplained swallowing difficulties and requires further evaluation

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What is form modified barium swallow?

The modified barium swallow is a radiographic examination that evaluates the swallowing function of the esophagus using barium contrast material. It helps diagnose swallowing disorders.

Who is required to file form modified barium swallow?

Typically, healthcare providers or specialists who order or conduct the modified barium swallow study are responsible for filing any associated forms as part of the patient's medical record.

How to fill out form modified barium swallow?

To fill out a modified barium swallow form, the healthcare provider should include patient information, the reason for the test, relevant medical history, and any findings from the examination.

What is the purpose of form modified barium swallow?

The purpose of the modified barium swallow examination is to assess the structure and function of the swallowing process and to identify any abnormalities that may lead to swallowing difficulties.

What information must be reported on form modified barium swallow?

The form must report patient demographics, the indication for the test, results of the swallowing evaluation, any observations noted during the study, and recommendations for further management.