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How to fill out the Ucla Radiology Forms online
Filling out the Ucla Radiology Forms online is a crucial step in ensuring that you receive the necessary imaging services. This guide provides you with clear instructions to navigate through the form smoothly and accurately.
Follow the steps to fill out the Ucla Radiology Forms online
- Click ‘Get Form’ button to access the form and open it in the editor.
- Begin by entering the Medical Record Number (MRN) and the patient’s name clearly in the designated fields.
- Under the 'Radiology Order' section, specify the procedures requested by selecting the appropriate option from the list provided. Ensure to check any necessary contrast requirements for CT or MRI scans.
- Indicate the diagnosis by selecting between 'Adult' or 'Peds' option, as well as providing a succinct clinical history pertinent to the radiology consultation.
- Fill in the IV access information, including the type of access (Peripheral, Central, PICC Line) and site, if applicable.
- List any precautions or allergies that are relevant, such as iodine or latex, to ensure patient safety during the procedure.
- Provide details regarding serum creatinine for CT, Angio, and MRI if required, including the value and date.
- Enter the requesting physician's name, contact phone, and relevant ID or beeper number.
- If the requesting physician is a resident or fellow, ensure to include the attending physician’s name and their UCLA ID/beeper number.
- Fill out the non-UCLA MD state license if required, and include information for where additional reports should be sent, including the recipient's name, fax number, and address.
- Complete the patient insurance information by checking the appropriate insurance type, and provide any precertification or authorization numbers along with the expiration date.
- Finally, ensure that the physician signature, date, and exact time are included before you save or submit the document.
Complete your Ucla Radiology Forms online now to ensure a smooth and efficient process.
Filing a complaint with UCLA Health is a straightforward process. You can contact their patient services department via phone or visit their website for guidance. They encourage you to provide detailed information regarding your concern. By filling out the appropriate UCLA Radiology Forms, you can help ensure that your complaint is addressed quickly and effectively.
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