Diagnostic imaging requisition 2026

1. Click ‘Get Form’ to open the diagnostic imaging requisition in the editor.
2. Begin by filling in the patient’s last name, first name, and health card number in the designated fields. Ensure that all information is printed clearly.
3. Enter the patient's date of birth (YYYY/MM/DD) and phone number. This information is crucial for appointment scheduling.
4. In the 'Clinical Information' section, provide any mandatory details regarding prior relevant exam history. This helps healthcare providers understand the patient's background.
5. Specify the examination requested in the appropriate field. Be as detailed as possible to avoid any confusion during processing.
6. Have the physician print their name and provide a mandatory signature along with the date of signing. This validates the requisition.
7. Complete any additional appointment details if required, ensuring all sections are filled out accurately before saving or sharing your document.

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