Get Sherman College Of Chiropractic Digital X-ray Request Form 2020-2025

Filling out the Sherman College Of Chiropractic Digital X-Ray Request Form online is a straightforward process that ensures accurate imaging requests. This guide will walk you through each section of the form to help you complete it efficiently.

Follow the steps to successfully complete the request form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin with the patient information section. Enter the patient's name, appointment date, and date of birth. Users should ensure accuracy for proper identification and scheduling.
3. Indicate the patient's gender by selecting the appropriate checkbox for 'Male' or 'Female'. This information can be important for specific imaging protocols.
4. Select the types of spinal X-rays requested. Users can indicate cervical, thoracic, or lumbar X-rays by checking the relevant boxes. For cervical X-rays, specify the views such as lateral, APOM, nasium, etc.
5. For each selected spinal region, provide any necessary additional details, such as the specific levels or requirements for 'Lateral Spot' or 'AP Spot' if applicable.
6. Fill in the appointment time to ensure the schedule aligns with the imaging request.
7. Complete the referring chiropractor information, including their name, date, phone number, and fax number. This helps the radiology department communicate effectively.
8. Select whether a copy should be sent with the patient, and if the referring chiropractor will pick up the results by checking the appropriate boxes.
9. Have the referring chiropractor or authorized user sign and date the form at the bottom. This confirmation is critical for processing the request.
10. After verifying that all fields are filled out correctly, users can save the changes, download, print, or share the completed form as required.

Complete your request form online today to ensure a smooth imaging process.