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This document serves as a requisition for various imaging services, including mammography, ultrasound, and bone mineral density tests. It outlines patient preparation guidelines, physician signature requirements, and special considerations for patients, ensuring compliance with healthcare protocols.

How to fill out diagnostic imaging requisition

How to fill out diagnostic imaging requisition

1. Obtain the diagnostic imaging requisition form from the healthcare facility or download it from their website.
2. Fill out the patient's personal information, including full name, date of birth, and contact information.
3. Provide the referring physician's details, including name, contact number, and any relevant identification numbers.
4. Specify the type of imaging required (e.g., X-ray, MRI, CT scan), including any specific body parts or conditions to be examined.
5. Indicate the reason for the imaging study, such as symptoms, diagnosis, or follow-up care.
6. Ensure all required fields are completed, including any checkboxes for urgency or special instructions.
7. Sign and date the requisition as the referring physician or authorized personnel.
8. Deliver the completed requisition to the imaging department or provide it to the patient for their appointment.

Who needs diagnostic imaging requisition?

1. Patients who are experiencing symptoms that require further investigation.
2. Healthcare providers seeking to confirm a diagnosis or assess a patient's condition.
3. Individuals requiring routine screenings as part of preventive healthcare measures.
4. Doctors looking for follow-up imaging after treatment or surgery.

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What is diagnostic imaging requisition?

A diagnostic imaging requisition is a formal request made by a healthcare provider for a patient to undergo imaging studies such as X-rays, MRIs, or CT scans.

Who is required to file diagnostic imaging requisition?

Typically, licensed healthcare professionals such as physicians, nurse practitioners, or physician assistants are required to file a diagnostic imaging requisition.

How to fill out diagnostic imaging requisition?

To fill out a diagnostic imaging requisition, the healthcare provider must include patient information, the specific imaging requested, relevant medical history, and any special instructions or concerns.

What is the purpose of diagnostic imaging requisition?

The purpose of a diagnostic imaging requisition is to ensure that the imaging procedure is justified, correctly directed, and that all necessary information to interpret the results is provided.

What information must be reported on diagnostic imaging requisition?

The information that must be reported includes patient identification details, clinical history, the specific imaging study requested, and any pertinent clinical findings.