Patient Service Center - Valley Baptist Medical Center - valleybaptist 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient’s name and date of birth in the designated fields. This information is crucial for identifying the patient.
3. Fill in the exam appointment date and time to ensure accurate scheduling.
4. Provide a detailed diagnosis and clinical history in the respective sections, as this information is essential for medical staff.
5. Complete the allergies section, indicating any known allergies, particularly to iodine, which is vital for contrast studies.
6. If applicable, fill out the BUN and Creatinine lab values required for IV contrast studies. Ensure you note the date drawn.
7. Select any necessary lab orders from the provided list, ensuring all required tests are included.

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