Get Physician Order Form Imaging Services - Ohsu
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How to fill out the Physician Order Form Imaging Services - OHSU online
Filling out the Physician Order Form Imaging Services at OHSU is an important step in ensuring that patients receive the appropriate imaging services. This guide provides clear and supportive instructions on how to complete the form accurately online, catering to users with varying levels of experience.
Follow the steps to fill out the form accurately and efficiently.
- Click the ‘Get Form’ button to obtain the form and open it for editing.
- Enter the required patient information, including the patient's name, date of birth, and phone number. Make sure to mark the appropriate scheduling options, based on the type of imaging service needed.
- Fill in the ICD 10 code and the associated diagnosis to ensure proper billing and care. Provide an authorization number, if applicable, and clearly state the reason for the exam.
- Complete the requesting physician information section. Input the physician's name and phone number, and ensure their signature is included.
- Select the type of exam required. Be specific about options such as MRI, CT, ultrasound, or any other service by marking the appropriate checkboxes.
- If applicable, specify the focus of the exam by selecting the relevant anatomical regions or conditions addressed in the imaging service.
- Respond to the required questions related to patient preparation, ensuring to follow any specific instructions for the selected imaging exam.
- Provide reminders for patient instructions, including the necessity of bringing an insurance card and any preparation requirements before the appointment.
- Once all fields have been accurately filled, save changes to the document. Users can then download, print, or share the form as necessary.
Start completing the Physician Order Form Imaging Services online to ensure the best care for your patients.
If the worksheet is protected, do the following: On the Review tab, click Unprotect Sheet (in the Changes group). Click the Protect Sheet button to Unprotect Sheet when a worksheet is protected. If prompted, enter the password to unprotect the worksheet.
Fill Physician Order Form Imaging Services - Ohsu
If over pt is over 300lbs, please indicate height and weight on order form. MRI table limit is 550lbs, measurements required on order form. REMINDERS: • Please ask patient to call Radiology scheduling at to schedule their imaging. REMINDERS: • Please ask patient to call Radiology scheduling at 5034180990 to schedule their imaging. REMINDERS: • Please ask patient to call Molecular Imaging and Therapy scheduling at to schedule their imaging. To submit the Physician Order Form, you can fax it to or email it directly to the radiology department. REMINDERS: • Please ask patient to call Nuclear Medicine scheduling at to schedule their imaging. Patient Name. DOB. Height.
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