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- Click ‘Get Form’ to open the imaging putrajaya hpjnuk 001 form in the editor.
- Begin by filling in the patient’s personal details, including their name, I/C number, date of birth, gender, ethnic group, age, contact number, and address. Ensure all fields are completed accurately.
- In the relevant medical history section, indicate any conditions such as diabetes or claustrophobia by ticking the appropriate checkboxes. If information is unavailable, mark with a dash (-).
- Provide clinical diagnosis and primary site of disease. Clearly state the reason for the PET/CT study and include any relevant findings from clinical examinations or previous imaging.
- Complete the clinical indication section by selecting applicable options for staging or restaging. Fill in additional details as required.
- Finally, ensure that the referring consultant's details are filled out correctly along with their signature and contact information before submitting.
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