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Cardiac Diagnostic Imaging Requisition CT, MRI, RAY Booking / Information / Cancellations Phone: 6137615115 Fax: 6137614416 40 Ruskin Street, Ottawa ON K1Y 4W7 www.ottawaheart.ca PRIORITY: Surname

How to fill out cardiac diagnostic imaging requisition

How to fill out a cardiac diagnostic imaging requisition:

1. Start by obtaining the requisition form from the healthcare facility where the cardiac diagnostic imaging will take place. This form can usually be obtained from the radiology department or imaging center.
2. Fill out the patient's information accurately. Include the patient's full name, date of birth, gender, and contact information. It is crucial to ensure that the patient's details are entered correctly to avoid any confusion or delays in the imaging process.
3. Provide the referring physician's information. Include the name, contact information, and any relevant identification numbers of the physician who is referring the patient for the cardiac diagnostic imaging. This information helps in communicating the results of the imaging study back to the referring physician.
4. Specify the type of cardiac diagnostic imaging required. The requisition form may have options for different imaging modalities such as echocardiography, cardiac stress testing, cardiac CT scan, or cardiac MRI. Select the appropriate imaging modality based on the patient's symptoms, medical history, and the referring physician's recommendation.
5. Indicate the reason for the cardiac imaging. It is essential to provide a brief explanation or clinical indication for the imaging study. This can include symptoms, suspected cardiac conditions, or the need for further evaluation of a known cardiac condition. The more specific the indication is, the better it will guide the imaging technologists during the procedure.
6. Include any necessary supporting documentation or orders. If there are any additional instructions or specific imaging protocols requested by the referring physician, make sure to attach them along with the requisition form. This can include previous imaging reports, relevant medical records, or specific technical requirements for the study.

Who needs a cardiac diagnostic imaging requisition?

1. Patients with suspected or known cardiac conditions: Individuals who are experiencing symptoms such as chest pain, shortness of breath, palpitations, or other cardiac-related symptoms may require cardiac diagnostic imaging. Additionally, patients with pre-existing cardiac conditions may need regular imaging studies to monitor their ongoing treatment or assess disease progression.
2. Referring physicians: Physicians who suspect or want to evaluate a cardiac condition in their patients may need to fill out a cardiac diagnostic imaging requisition. This allows them to request the necessary imaging studies and gather more information about a patient's cardiac health.
3. Healthcare facilities and imaging centers: The staff at healthcare facilities, including radiology departments and imaging centers, require a cardiac diagnostic imaging requisition to properly schedule and perform the requested imaging procedure. The requisition provides essential information about the patient's medical history, clinical indication, and the type of imaging study required.

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What is cardiac diagnostic imaging requisition?

Cardiac diagnostic imaging requisition is a form used to request specific imaging tests to evaluate the heart and surrounding structures.

Who is required to file cardiac diagnostic imaging requisition?

Cardiologists, primary care physicians, and other healthcare providers involved in the care of the patient may be required to file the cardiac diagnostic imaging requisition.

How to fill out cardiac diagnostic imaging requisition?

The requisition form should be filled out by the healthcare provider with relevant patient information, test requested, and reason for the test.

What is the purpose of cardiac diagnostic imaging requisition?

The purpose of the cardiac diagnostic imaging requisition is to ensure that appropriate imaging tests are ordered to diagnose or monitor heart conditions.

What information must be reported on cardiac diagnostic imaging requisition?

The requisition form should include patient demographics, relevant medical history, reason for the test, type of test requested, and any other pertinent information.

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