Get Radiology Request Form - Wesley Medical Imaging

Completing the Radiology Request Form at Wesley Medical Imaging is a straightforward process that can be done online. This guide provides clear and concise instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete the Radiology Request Form online.

1. Press the ‘Get Form’ button to acquire the Radiology Request Form and open it in the available editing tool.
2. Begin by entering patient details, which include the patient's name, date of birth, address, Medicare number, and phone number. Ensure that all information is correct to facilitate seamless processing.
3. Specify the examination required. Clear communication regarding the correct side and site is essential, along with ensuring patient data accuracy and the use of side markers, as indicated by the radiographer’s initials.
4. Fill in the clinical history section. It may be beneficial to include relevant medical background that could assist in the examination process.
5. If the patient is over 60 years and requires IV contrast, provide the e-GFR (estimated Glomerular Filtration Rate) in the appropriate field.
6. Include the signature and date in the patient declaration of consent section, indicating consent to the use of personal information for treatment purposes.
7. Complete the referring doctor's details by entering the doctor’s name and including their signature if necessary.
8. Review all fields for accuracy before finalizing. Make sure that all necessary fields are completed and information is accurate.
9. Once completed, you can save any changes you made, download the form for your records, print it if you need a physical copy, or share the form as required.

Start filling out your Radiology Request Form online today for a smooth and efficient process.