Get Ultrasound Order Form

Filling out the ultrasound order form online is a straightforward process that ensures accurate submission of necessary medical information. This guide will walk you through each section of the form, providing step-by-step instructions to help you complete it efficiently.

Follow the steps to successfully complete your ultrasound order form

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred browser.
2. Begin by entering the patient's information, including their last name, first name, middle initial, and phone number in the designated fields.
3. Provide the billing information by selecting the appropriate payer option, such as Medicare, Medi-Cal, or private insurance. Include the patient's date of birth and the desired date of service.
4. Next, fill out the ultrasound studies section by selecting the relevant studies and specifying any associated symptoms or conditions from the provided list.
5. Review the list of non-invasive vascular studies and cardiac studies, selecting any applicable tests based on the patient's needs.
6. Ensure the ordering physician's signature is included, along with their National Provider Identifier (NPI) number for verification.
7. Once all fields are complete, save your changes, and choose the option to download, print, or share the completed form as necessary.

Complete your ultrasound order form online today for a seamless submission process.