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Request Form Of Radiology (X-ray). - radiologystar

what is Request Form Of Radiology (X-ray). 

An x-ray request form is a document that is used to request x-ray imaging services from a diagnostic imaging center or hospital. Radiology request forms are the basis of communication between referring physicians and radiologists. The form typically includes information about the patient, such as their name, date of birth, and medical history, as well as information about the x-ray that is being requested, such as the type of x-ray (e.g. chest x-ray, hip x-ray, etc.) and the reason for the x-ray.
The form may also include information about the ordering physician, such as their name and contact information. This is so that the imaging center can contact the physician with any questions or concerns they may have about the x-ray request, or to provide them with the results of the x-ray when it is completed.
A Request Form may also include details of the Patient’s symptoms, symptoms which lead to the request, any previous medical history related to the x-rayed body part, any prior medical imaging of the same body part.
The x-ray request form is usually generated by the patient’s primary care physician or referring physician, but it can also be generated by other healthcare professionals, such as a nurse practitioner or physician assistant. The patient or their authorized representative typically signs the form to give consent for the x-ray to be performed.
 X-Rays Requisition Form Including Following Points:-
1. Name of Patient:- The name of patient should be written along with surname because many time receive two or more patient but surname are different.
2. X-ray number:- X-ray number is different because there are several film to mix up darkroom during the processing.
3. Date:- In certain case investigation is done with in particular period so that date on which investigation is being required.
4. Referring unit:- There are various department in hospital such as Surgery, Neurosurgery, Neurology, Pediatrics, Orthopedics, Gastroenterology , ENT , Dental , etc . so it become quite difficult to send x-ray report to particular department.
5. CR Number:- Number given after registration of patient in hospital which indicate its identity address and patient is referred to particular department.
6. Indoor/ Outdoor:- Patient coming for investigation through O.P.D or the patient admitted through ward in which patient X-ray sent to particular department.
7. Examination required:- Investigation is done according to requirement with particular view.
8. Clinical information:- History of the patient
9. Signature of the Medical officer :- The signature of the concern department doctor should check whether the requisition is made by proper Medical Officer.
10. Any history of Allergy:- History of Allergy to the patient is important because certain investigation contrast media are injected directly in to veins.
11. L.M.P :- This is generally required to know whether the.female is pregnant or not. In certain cases is pregnancy is not in particular time period the intravenous contrast media are not.
12. Any previous X-rays :- This is indicate in certain case to rule out a disease.
13. Radiographers use:- In big hospital there are different x-ray room to do x-ray procedure and more special investigation in particular days. The radiographer should write room number , the size and number of film consume for particular investigation exposure applied.
14. Report:- The report is written by the radiologist in detail and signed.

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