Get Nc Novant Health Imaging Triad Requisition Form 2013-2025

Filling out the NC Novant Health Imaging Triad Requisition Form online is a straightforward process that enhances efficiency and accuracy. This guide provides you with step-by-step instructions to ensure that you complete the form correctly and submit it without any issues.

Follow the steps to accurately complete the requisition form.

1. Click ‘Get Form’ button to obtain the requisition form and open it in the editor.
2. Begin by entering the patient name and date of birth in the designated fields. These details are crucial for identification.
3. Input the insurance precertification number along with the patient's contact phone number. This information ensures that the insurance coverage is verified.
4. Specify the appointment details, including the date and check-in time. Accurate timings facilitate better scheduling.
5. Provide specific symptoms or the reason for the study in the designated section. This helps the medical team understand the context of the examination.
6. Identify the ordering physician by filling in their name and phone number. This creates a direct point of contact if further clarification is necessary.
7. Ensure to check the appropriate boxes for STAT exam requests or film instructions if applicable. This indicates priority or special handling requirements.
8. Carefully select the areas of the body that require examination under the appropriate sections for imaging modalities (e.g., CT, MRI, X-ray).
9. Review any patient preparation or special instructions that may be relevant depending on the type of imaging requested.
10. Once all fields are completed, you can save changes, download, print, or share the form as needed for submission.

Begin the process now by completing the NC Novant Health Imaging Triad Requisition Form online.