Get Radiology Request Form Sloane Diagnosti C Imaging

Filling out the Radiology Request Form at Sloane Diagnostic Imaging is a straightforward process. This guide will walk you through each section and field to ensure a smooth experience in submitting your request online.

Follow the steps to complete your radiology request form accurately.

1. Press the ‘Get Form’ button to obtain the radiology request form and open it in your preferred editing tool.
2. Begin by selecting the type of examination needed. You can choose from X-ray, CT, Ultrasound, or MRI by ticking the appropriate box.
3. Fill in the patient's details including their name, title, date of birth, and gender (male or female). Make sure to provide an accurate address and postcode for effective communication.
4. Enter the relevant telephone numbers. Include home, in-patient, and work numbers, as well as the ward if applicable.
5. Specify the name of the hospital where the patient is being treated along with their hospital number and associated telephone number.
6. Identify who is responsible for the patient's account by selecting either the patient, another party, or NHS.
7. For MRI patients, make sure to note any contraindications such as intra-orbital foreign bodies or pregnancy, as this information is crucial for safety.
8. Provide clinical information as required. This is mandatory to proceed with the examination as per Ionising Radiation Medical Exposure Regulations 2000.
9. Obtain the referring clinician's signature and date it. Include their name, telephone number, and address for report purposes.
10. If the patient is female and between 12-55 years old, indicate if they are pregnant by marking ‘Yes’ or ‘No’.
11. Complete the radiographer's section, providing the operator's name, billing code, dose, the reporting radiologist, and the date of the scan.
12. After ensuring all sections are filled in accurately, save your changes. You can then download, print, or share the form as needed.

Complete your radiology request form online today for a hassle-free experience.