Get Ara Scheduling 512

The ARA SCHEDULING 512 form is essential for scheduling PET/CT examinations at the Austin Radiological Association. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to fill out the ARA SCHEDULING 512 form online.

1. Click ‘Get Form’ button to obtain the ARA SCHEDULING 512 form and access it in the online editor.
2. Begin with the ‘Patient Information’ section. Enter the patient's name, date of birth, and contact phone numbers. This information is crucial for identifying the patient.
3. In the ‘Referring Information’ section, include the referring physician's name and signature, along with the date. Ensure that this section is complete to avoid delays.
4. Fill out the ‘PET/CT Exam Requested’ section by selecting the type of scan required by marking the appropriate option, which may include 'PET/CT (skull base to thighs)' or other specific types listed.
5. Indicate whether a diagnostic CT is requested in addition to the PET/CT by selecting 'Yes' or 'No.' If 'Yes,' specify whether it is with or without IV contrast and provide details for the areas specified.
6. In the ‘Primary Diagnosis’ field, provide the diagnosis along with the appropriate ICD code to ensure proper billing and documentation.
7. Complete the ‘Reason for Study’ section by indicating whether this is for initial treatment strategy or subsequent treatment strategy, and mention how many prior PET/CT scans the patient has undergone.
8. Fill in details regarding any recent surgeries, relevant imaging, chemotherapy types, and dates of last treatments as required in the respective fields.
9. Confirm the patient’s diabetes status and list medications, if applicable, to ensure accurate preparation for the examination.
10. At the end of the form, make sure to confirm the checklist for the physician's office is complete, including required documents, and ensure both the physician's and patient's signatures are provided.
11. Once all relevant information is filled out accurately, save the changes, and utilize options to download, print, or share the completed form as needed.

Complete your ARA SCHEDULING 512 form online today to ensure a smooth scheduling process.