Here's how it works
01. Edit your sutter diagnostic imaging order form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out diagnostic imaging order with our platform
- Click ‘Get Form’ to open the diagnostic imaging order in the editor.
- Begin by entering the patient's name and date of birth in the designated fields. This information is crucial for identifying the patient.
- Select the type of exam requested by checking the appropriate box (MRI, CT, US, NUCMED, XRAY, FLOURO). Ensure that you choose only one option.
- Fill in the diagnosis and ICD 10 code in their respective fields. This helps in providing accurate medical information for processing.
- Provide any relevant patient history and special instructions or additional exams needed. This section allows for personalized care.
- Complete the insurance details including carrier, phone number, and authorization number. Attach a copy of the insurance card as required.
- The ordering provider must sign and print their name along with the date. Include contact information such as phone and fax numbers.
- Lastly, specify where to send reports by listing names and locations in the provided space.
Start using our platform today to streamline your diagnostic imaging orders for free!
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