Northwestern medical group dupage 2026

1. Click ‘Get Form’ to open the northwestern medical group dupage order form in the editor.
2. Begin by filling out the 'Patient Information' section. Enter the patient's last name, first name, date of birth, and both home and work/cell phone numbers.
3. Next, move to the 'Physician Information' section. Input the physician's first name, fax number, NPI number, and ensure to sign and date the form.
4. In the 'Signs and Symptoms/Diagnosis/ICD Code(s)' area, clearly indicate any relevant signs, symptoms, or diagnoses for each test requested. Avoid using vague terms like 'rule-out'.
5. Select the appropriate tests from the list provided. Mark each test required for imaging clearly by indicating right (R) or left (L) as necessary.
6. Finally, review all entered information for accuracy before submitting your completed order via fax to expedite processing.

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