The requisites nuclear medicine pdf 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name, age, and the date at the top of the form. This information is essential for identification purposes.
3. In the 'Reason for this examination' section, provide a brief description of why you are undergoing this nuclear medicine study.
4. Indicate whether you have had a previous Nuclear Medicine study by selecting 'Yes' or 'No'. If yes, fill in the date and location of that study.
5. For recent exams, check all applicable imaging studies (PET, CT, MRI, Ultrasound, X-ray) and provide details as necessary.
6. If applicable, detail any prior surgeries or treatments by filling in the type and dates of surgery.
7. Cancer patients should indicate chemotherapy and radiation therapy details along with dates and affected body parts.
8. Report any recent injuries by checking 'Yes' or 'No', specifying the body part injured if applicable.
9. List current medications and any known allergies to medications in their respective sections.
10. Female patients should complete sections regarding menstrual history and pregnancy status as required.

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