Get Ultrasound Order Form

This guide provides comprehensive instructions on filling out the Ultrasound Order Form online, ensuring that all necessary information is accurately captured to facilitate effective scheduling and processing of ultrasound tests. Follow these steps to complete the form with ease.

Follow the steps to accurately complete the Ultrasound Order Form online.

1. Click the 'Get Form' button to access the Ultrasound Order Form and open it in your preferred online editor.
2. Select the facility where the test is scheduled by marking the appropriate checkbox next to the facility name.
3. Provide the patient's legal name and date of birth in the designated fields to identify the individual undergoing the ultrasound.
4. Indicate the test date and time you wish to schedule by filling in these details in their respective fields.
5. In the clinical indications section, enter complete and specific clinical information necessary for the radiologist to supervise the scanning and meet insurance requirements.
6. Specify where to send the report by checking the appropriate box (phone, pager, or fax) and providing the relevant number if applicable.
7. Indicate any additional items such as whether to hold the patient or if a CD of the results is needed.
8. Choose the type of ultrasound needed by marking the relevant checkboxes under the appropriate sections (e.g., abdomen, pelvis, breast). Ensure to provide any additional specifics required.
9. Fill out the physician signature, date, and time fields to validate the order.
10. Once all necessary fields have been completed, you can save changes, download, print, or share the form as required.

Complete your ultrasound order forms online effortlessly and ensure timely scheduling for your patients.