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Queen Elizabeth Hospital Prince County Hospital: (902) 8940067 Scheduling: (902) 8942457Ph: (902) 8940067 Scheduling
Fax: (902) 8942457ECHOCARDIOGRAM REQUEST
PRIORITY (Mandatory):PATIENT INFORMATIONHealth
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How to fill out echocardiogram request
How to fill out echocardiogram request
01
Obtain the echocardiogram request form from the healthcare provider.
02
Fill out the patient's demographic information including name, date of birth, and medical record number.
03
Provide information on the reason for the echocardiogram and any relevant medical history.
04
Indicate the type of echocardiogram being requested (transthoracic, transesophageal, stress, etc.)
05
Include any additional instructions or special requirements if necessary.
06
Sign and date the form before submitting it to the imaging facility.
Who needs echocardiogram request?
01
Patients with suspected heart conditions or abnormalities.
02
Healthcare providers such as cardiologists, internists, or primary care physicians.
03
Medical facilities or imaging centers where echocardiograms are performed.
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What is echocardiogram request?
An echocardiogram request is a formal order from a physician or healthcare provider to perform an echocardiogram, which is a type of ultrasound that provides images of the heart's structure and function.
Who is required to file echocardiogram request?
Typically, healthcare providers such as cardiologists or primary care physicians are required to file an echocardiogram request on behalf of their patients.
How to fill out echocardiogram request?
To fill out an echocardiogram request, a healthcare provider should include patient information, the specific type of echocardiogram requested, clinical indications, and any relevant medical history or symptoms.
What is the purpose of echocardiogram request?
The purpose of an echocardiogram request is to diagnose and evaluate heart conditions, assess heart function, and guide treatment decisions based on the ultrasound findings.
What information must be reported on echocardiogram request?
The echocardiogram request must include the patient's name, date of birth, medical record number, reason for the test, specific type of echocardiogram, and relevant clinical information.
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