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Name: Fillable Online 2023 Nuclear Medicine Requisition Form for Diagnostic Imaging Services Fax Email Print - pdfFiller
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Complete the Nuclear Medicine Requisition for accurate diagnostic imaging services at PRHC. Include patient and physician information along with requested tests.

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What is nuclear medicine requisition?

A nuclear medicine requisition is a formal request for nuclear medicine imaging or therapeutic procedures, typically initiated by a physician to ensure that the necessary tests are performed for diagnosis or treatment.

Who is required to file nuclear medicine requisition?

The healthcare provider or physician who is requesting the nuclear medicine procedure is required to file the nuclear medicine requisition.

How to fill out nuclear medicine requisition?

To fill out a nuclear medicine requisition, the healthcare provider should include patient information, specific procedure requested, medical history, reason for the exam, physician's information, and any relevant clinical data.

What is the purpose of nuclear medicine requisition?

The purpose of nuclear medicine requisition is to communicate essential information about the patient and the requested procedure to the nuclear medicine department to ensure accurate and appropriate imaging or treatment.

What information must be reported on nuclear medicine requisition?

The information that must be reported includes patient demographics (name, age, sex), clinical indication, procedure details, relevant medical history, and physician's contact information.

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