Get the free PEDIATRIC IMAGING CENTER ORDER FORM

Glue PEDIATRIC IMAGING CENTER ORDER FORM PIC APPOINTMENTS: (205) 6382378 or 18002264770 Fax: (205) 6384803 Pediatric Imaging Center/ Children's South 1940 Elmer J. Bissell Road Birmingham, AL 35243

How to fill out pediatric imaging center order

How to fill out a pediatric imaging center order?

1. Begin by gathering all necessary information: Collect the patient's personal details, including their full name, date of birth, gender, and contact information. It is crucial to have accurate and up-to-date information to ensure proper identification and communication.
2. Provide the patient's medical history: Include any relevant medical records, such as previous diagnoses, current medications, known allergies, and other pertinent information. This data helps the healthcare professionals in charge of the imaging procedure to tailor it to the individual needs of the patient.
3. Specify the type of imaging requested: Indicate the specific imaging modality required, such as X-ray, MRI, CT scan, or ultrasound. Be sure to describe the body part or area that needs to be examined properly.
4. Indicate the reason for the imaging request: Clearly state the medical purpose or symptoms that led to the recommendation for the imaging procedure. This information assists the radiologists in interpreting the images accurately and providing a more comprehensive analysis.
5. Include any additional instructions or requirements: If there are any special instructions from the referring physician, such as fasting before the procedure or specific preparations, make sure to note them down in the order. This helps to ensure that the patient is adequately prepared for the imaging appointment.
6. Provide insurance and billing information: Include the patient's insurance details, such as policy number and contact information, as well as any relevant authorization or pre-approval numbers. Additionally, if the imaging center requires specific billing information, include it in the order to avoid any delays or issues with payment.
7. Confirm the referring physician's information: Clearly state the name, address, and contact details of the referring physician. This allows the imaging center to get in touch with the referring doctor if necessary for any follow-up information or clarification.

Who needs a pediatric imaging center order?

1. Pediatric patients: Children who require medical imaging as part of their diagnosis or treatment plan need a pediatric imaging center order. This ensures that the procedure is conducted safely and tailored to their specific needs, considering their age, size, and medical conditions.
2. Referring physicians: Healthcare providers who suspect that a pediatric patient may require imaging services can issue a pediatric imaging center order. This enables them to communicate their clinical concerns and diagnostic requirements to the imaging center, facilitating a more targeted and effective examination.
3. Radiologists and imaging technologists: The professionals conducting the imaging procedures rely on the pediatric imaging center order to guide them through the process. It provides essential information about the patient, their condition, and the imaging modality requested, helping them perform the procedure accurately and provide accurate interpretations of the images.

Overall, filling out a pediatric imaging center order requires careful attention to detail and clear communication of the patient's information, medical history, and imaging requirements. this ensures a successful imaging procedure and accurate diagnosis for the pediatric patient in question.

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