Get Uw Medicine Radiology Order Form 2018

Filling out the UW Medicine Radiology Order Form online is a straightforward process that ensures all necessary information is captured efficiently. This guide will help you navigate each section of the form with clear instructions, making it easy for all users.

Follow the steps to complete your radiology order form

1. Click ‘Get Form’ button to obtain the radiology order form and open it in your preferred editing tool.
2. Begin by entering the patient's last name and first name in the designated fields. Ensure accuracy to avoid any processing issues.
3. Provide the daytime and evening phone numbers. This information is crucial for contacting the patient if necessary.
4. Input the insurance carrier details, including the RQI/authorization number and insurance ID number, if applicable.
5. Indicate the date of birth and gender of the patient, along with their weight and any interpreter or language requirements.
6. If applicable, fill in the workers' compensation date of injury and claim number.
7. In the exam information section, specify the exact area of interest and provide the reason for the exam. This information helps healthcare providers prepare for the imaging needed.
8. Indicate the history or reasons for the exam, and list any questions to be answered by imaging.
9. Select the relevant imaging type, whether it be MRI, CT, ultrasound, or another modality, and indicate if contrast is needed.
10. Provide notes if the exam is clinically urgent, including any necessary details about related imaging.
11. In the provider section, ensure the provider signature is filled in along with their printed name, phone number, and date. Note that a rubber stamp is not acceptable.
12. Finally, save your changes, and you can opt to download, print, or share the completed form as needed.

Complete your UW Medicine Radiology Order Form online today for a seamless experience.