Get Ir Form - Iris Radiology

Filling out the IR Form - Iris Radiology online is a straightforward process that allows you to request imaging interpretations easily. This guide will provide you with clear, step-by-step instructions to complete each section of the form accurately.

Follow the steps to complete the IR Form - Iris Radiology online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the order date at the top of the form in the format: MM/DD/YYYY.
3. Indicate who is requesting the consultation or report by selecting one of the options: 'Doctor', 'Imaging Facility', 'Patient', 'Attorney', or 'Other' by marking the appropriate checkbox.
4. If the request is made by a doctor, provide their name and specialty, ensuring you select the correct degree (MD, DO, DC, DPM). If 'Other' is selected, specify the relationship to the patient.
5. Enter the contact information including phone number, fax, and cell phone, as well as the complete address, city, state, country, and zip code.
6. In the 'Information Needed for Interpretation and Report' section, choose how you would like to receive the report by selecting either 'Fax' or 'Email' and provide the necessary contact details.
7. Input the patient's name, date of birth in the format MM/DD/YYYY, and select the sex by marking 'M' or 'F'.
8. Specify the type of procedure and anatomical area for the imaging. List multiple procedures and areas as needed in the provided spaces.
9. Provide any relevant diagnosis or additional instructions in the designated sections.
10. Complete the 'Fees and Calculation Area' by indicating the number of anatomical regions being examined and calculating the total costs based on the pricing provided.
11. Choose the payment method by selecting the appropriate option, whether it's by check, money order, or credit card. Fill in the required card details if applicable.
12. Finally, review all entries for accuracy, save your changes, and then you can download, print, or share the completed form as needed.

Complete your IR Form - Iris Radiology online today to ensure timely access to your imaging interpretations.