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ELLESMERE CLINICMILLIKEN CLINIC2880 ELLESMERE ROAD TORONTO, ON M1E 4B8 TEL: (416) 2841697 FAX: (416) 2841780 GENERAL RAY MSK ULTRASOUND BONE MINERAL DENSITOMETRY VASCULAR ULTRASOUND MAMMOGRAPHY4040
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How to fill out request for outpatient diagnostic

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How to fill out request for outpatient diagnostic

01
Obtain the necessary referral from your primary care physician or specialist.
02
Contact the healthcare facility where you wish to have the outpatient diagnostic procedure done.
03
Provide your personal information including name, date of birth, contact information, and any relevant medical history.
04
Schedule an appointment for the outpatient diagnostic procedure.
05
Follow any pre-procedure instructions provided by the healthcare facility.
06
Arrive on time for your appointment and bring any required documentation or insurance information.
07
Complete any paperwork or consent forms required before the procedure.

Who needs request for outpatient diagnostic?

01
Individuals who have been referred by their primary care physician or specialist for further diagnostic testing.
02
Patients who are experiencing symptoms that require additional evaluation through outpatient diagnostic procedures.
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Request for outpatient diagnostic is a formal request made by a healthcare provider for a patient to undergo diagnostic tests or procedures on an outpatient basis.
The healthcare provider or physician is required to file the request for outpatient diagnostic on behalf of the patient.
The request for outpatient diagnostic form must be completed with patient's demographic information, the specific tests or procedures requested, and the reason for the diagnostic request.
The purpose of request for outpatient diagnostic is to facilitate the ordering and scheduling of diagnostic tests or procedures for a patient outside of a hospital setting.
The request for outpatient diagnostic must include patient's name, date of birth, insurance information, referring provider's name, type of test or procedure requested, and clinical indication.
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