Umass radiology requisition form 2026

1. Click ‘Get Form’ to open the umass radiology requisition form in the editor.
2. Begin by entering the patient's name and MGH Unit number in the designated fields. This information is crucial for identifying the patient.
3. Next, fill in the physician's name, phone number, and MD provider number. Ensure that all contact details are accurate for effective communication.
4. In the 'Diagnosis/Symptoms' section, provide a brief description of the patient's condition. This helps in determining the appropriate imaging study.
5. Select all applicable imaging requests by checking the corresponding boxes. Options include ultrasound Doppler, CTA, and MRA among others.
6. If a consultation is needed, check the consultation box under the relevant category. This will initiate scheduling for a clinical appointment.
7. Finally, review all entered information for accuracy before submitting your request through our platform.

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