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Bone Densitometry History Sheet Name: ___ Date: ___ Referring Physician: ___ Please Circle: Male or Female Age: ___ Current Height: ___ Current Weight: ___ Age at Menopause ___ Ethnicity: Asian Black

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How to fill out bone densitometry history sheet

01

Start by providing personal information such as name, date of birth, and contact details.

02

Mention any relevant medical history including past fractures, family history of osteoporosis, and any medications being taken.

03

Specify if you have any risk factors for osteoporosis such as low body weight, smoking, or excessive alcohol consumption.

04

Record any previous bone density scans and their results, if applicable.

05

Sign and date the form to confirm the accuracy of the information provided.

Who needs bone densitometry history sheet?

01

Individuals undergoing bone density testing.

02

Patients with a history of fractures or risk factors for osteoporosis.

03

Healthcare professionals conducting bone densitometry scans.

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What is bone densitometry history sheet?

Bone densitometry history sheet is a document that contains information related to a patient's medical history, previous bone density tests, and any risk factors for bone disorders.

Who is required to file bone densitometry history sheet?

Healthcare providers, such as doctors or radiologists, are required to file the bone densitometry history sheet for their patients.

How to fill out bone densitometry history sheet?

The bone densitometry history sheet should be filled out by the healthcare provider based on the patient's medical records and history.

What is the purpose of bone densitometry history sheet?

The purpose of the bone densitometry history sheet is to help healthcare providers assess the patient's risk of bone disorders and determine the need for further testing or treatment.

What information must be reported on bone densitometry history sheet?

The bone densitometry history sheet must include the patient's personal information, medical history, previous bone density test results, and any risk factors for bone disorders.

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