Get Radiology Request Form - Bstpaulbborgbbhkb

Filling out the Radiology Request Form - Bstpaulbborgbbhkb online is a straightforward process designed to ensure you provide the necessary information for a successful radiology examination. This guide will lead you through each section to help you complete the form accurately and efficiently.

Follow the steps to fill out the Radiology Request Form online:

1. Press the ‘Get Form’ button to obtain the form and open it in the designated editor.
2. Fill in the patient information section, including the patient's name, sex, age, date of birth, and phone number.
3. Provide the referring doctor’s name and the appointment details, including date and time for the examination.
4. Attach the patient’s label if available, ensuring all personal information is accurately reflected.
5. Complete the clinical history or diagnosis section, providing relevant details that may assist with the examination.
6. Indicate the patient’s pregnancy status if applicable, alongside the use of IV contrast.
7. Record the last menstrual period and any history of allergies to prepare the medical staff for the examination.
8. Select the desired examination type by checking the appropriate boxes for the various imaging studies required.
9. For MRI examinations, be sure to complete the checklist located on the second page addressing medical history and conditions.
10. Conclude by ensuring the doctor’s signature or chop is obtained, followed by dating the request for proper documentation.
11. Finally, save your changes, download, print, or share the completed form as needed.

Complete your documents online now to ensure a smooth radiology examination process.