Get Pet Ct Request Form - Qscan.com.au

Filling out the PET CT Request Form is an important step in ensuring that you receive the appropriate imaging procedure. This guide provides a comprehensive overview of each section of the form to assist you in completing it accurately and efficiently.

Follow the steps to successfully complete your PET CT request

1. Click ‘Get Form’ button to access the PET CT Request Form and open it in your preferred document editor.
2. Begin by filling in the patient details section. You will need to provide the patient’s full name, birth date, contact information, and Medicare number.
3. Next, complete the clinical details section. Here, you should include the patient's height, weight, and any relevant medical history such as diabetes or renal impairment.
4. Specify the requested PET CT scan. Tick the appropriate box to indicate whether it is for a non-Medicare eligible PET CT scan or provide other specified indications.
5. The referring doctor's information must be filled out, including their name and contact details. Ensure this section is completed accurately, as it will facilitate communication regarding the patient's care.
6. If applicable, include details about any recent treatments the patient has undergone, such as surgery, radiation therapy or chemotherapy, along with the dates.
7. Finally, review the information you have entered for completeness and accuracy. Once reviewed, you can save changes, download the document, print it, or share it as necessary.

Complete your documents online today for a smoother healthcare experience.