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ATTENTION PATIENT PLEASE BRING THIS FORM TO YOUR APPOINTMENT* - radiology uic 2026

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The document is a Radiology Procedure Order Form for UIMC Hospital, detailing necessary patient information and instructions for various imaging procedures such as CT, MRI, X-Ray, and Ultrasound. It includes sections for patient demographics, appointment details, insurance information, and specific medical history related to contrast use. Additionally, it provides guidelines for patients and physicians regarding preparation for procedures and safety considerations.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information in the designated fields, including your name, date of birth, and contact numbers. This ensures that the clinic can reach you if necessary.
Next, specify your appointment date and time. This helps the clinic prepare for your visit.
Indicate your insurance details and select the procedure requested from the provided options. If contrast is needed, make sure to check 'Yes' or 'No' accordingly.
Answer health-related questions regarding pregnancy, claustrophobia, and any allergies. This information is crucial for your safety during procedures.
Complete any additional sections regarding medical history and physician details before saving or printing the form.

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How do you prepare a patient for radiology?

Remove all jewelry and eye make-up. Wear comfortable clothes without metal closures. Prior to your appointment, you will receive specific instructions concerning your exam. Most exams require no special preparation, but a few studies such as MRCP and MR enterography, require 4 hours of fasting. Patient Preparation | Radiology Associates Imaging Radiology Associates Imaging patient-pr Radiology Associates Imaging patient-pr

What should you do before a radiology test?

Therefore, your doctor will likely ask you not to eat or drink anything (including any medications taken by mouth, especially antacids) and to refrain from chewing gum after midnight on the day of the examination. You may be asked to remove some or all of your clothes and to wear a gown during the exam.

How do you prepare for radiology?

Preparation: Remove all metal objects and electronic devices. Some MRIs require fasting for a few hours before the exam. If contrast dye is used, you may need to avoid food or drink for a set period beforehand. What to Expect: MRIs use a powerful magnet and radio waves to create detailed images.

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How to prepare a patient for radiology?

The patient should have nothing to eat or drink for 6 hours prior to the imaging study, no caffeine for 12 hours prior to the study. If the study is performed on 2 separate days, then the patient should allow for 2 hours on the first day and 1 hour on the second day for this examination.

What should you not do before radiology?

Before the Examination Jewelry including rings, earrings, necklaces, or watches. Pens, pocketknives, and eyeglasses. Credit cards and other cards containing magnetic data. Pins, hairpins, and similar metallic items, which can distort MRI images. Clothing has metal hooks, buttons, zippers, or other metal items on it.

ATTENTION PATIENT PLEASE BRING THIS FORM TO YOUR APPOINTMENT* - radiology uic 2026

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How do I sign my **** ATTENTION PATIENT PLEASE BRING THIS FORM TO YOUR APPOINTMENT***** - radiology uic on iOS?

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How do you prepare a patient for radiology?

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How do you prepare for radiology?

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ATTENTION PATIENT PLEASE BRING THIS FORM TO YOUR APPOINTMENT* - radiology uic 2026

How to use or fill out ATTENTION PATIENT PLEASE BRING THIS FORM TO YOUR APPOINTMENT* - radiology uic

See more ATTENTION PATIENT PLEASE BRING THIS FORM TO YOUR APPOINTMENT* - radiology uic versions

How do I sign my ATTENTION PATIENT PLEASE BRING THIS FORM TO YOUR APPOINTMENT* - radiology uic on iOS?

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