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Get Uic Form Ui-3335 2011-2025
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How to fill out the UIC Form UI-3335 online
Filling out the UIC Form UI-3335 online is a straightforward process that helps facilitate your appointment at the imaging center. This guide provides a step-by-step approach to ensure you provide all necessary information accurately and efficiently.
Follow the steps to complete the UIC Form UI-3335 online.
- Press the ‘Get Form’ button to retrieve the form and open it for editing.
- Begin by entering the patient’s name in the designated field, followed by their date of birth.
- Provide contact information by filling in the patient phone number and an alternate phone number if available.
- Specify the appointment date and time using the provided fields.
- Indicate the insurance information, ensuring you include relevant details.
- Select the procedure requested from the list provided, marking any necessary contrast options.
- Answer the questions regarding pregnancy and claustrophobia by choosing 'Yes' or 'No'.
- If permission for IV or PO contrast is granted, continue to answer the risk factors question. If not, halt completion here.
- List risk factors as applicable and provide serum creatinine and GFR information, including the date of these tests.
- Indicate any allergies, particularly to contrast, and specify if the patient is on dialysis.
- Complete the other sections by filling out the patient weight, height, ICD-9 code, and clinical history.
- Print the attending physician's name and obtain their signature, adding pager or contact numbers.
- Finalize by adding the required date and time.
- Once everything has been properly filled out, save any changes, and you have the option to download, print, or share the completed form.
Start filling out your UIC Form UI-3335 online today to prepare for your appointment.
A 2.7 GPA can be a starting point, but it's typically considered below average for many colleges. Admissions committees look at your whole profile, including your personal achievements and motivation. If you're applying to schools like UIC, submitting the UIC Form UI-3335 can help underline your commitment and readiness for college-level work.
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