Tag Diagnostic Imaging

eForms, Imaging, ON, Paid Downloads, Radiology, Southwestern Ontario

LHSC SJH Nuclear Medicine Requisition

Nuclear Medicine Requisition for London Health Sciences Centre (LHSC) – Victoria Hospital (VH) and University Hospital (UH), and St. Joseph’s Hospital (SJH). London, Ontario. Includes automatic signature and X-boxes for marking body. Created by Adrian Starzynski Code Copyright Adrian Starzynski

Adrian Starzynski
September 18, 2023

eForms, Imaging, ON, Paid Downloads, Radiology, Southwestern Ontario

CT Spine Appropriateness Checklist South West LHIN

CT Spine Appropriateness Checklist South West LHIN / Spine CT Checklist SouthWest LHIN To be attached to CT Requisition if requesting CT scan of spine Includes automatic signature and body drawing diagram (draw with mouse). Created by Adrian Starzynski Code Copyright…

Adrian Starzynski
September 18, 2023

eForms, Imaging, ON, Paid Downloads, Radiology, Southwestern Ontario

CT Requisition South West LHIN

CT Requisition South West LHIN / SouthWest LHIN CT Requisition Includes automatic signature. Created by Adrian Starzynski See: CT Spine Appropriateness Checklist which is to be attached if requesting CT scan of spine Code Copyright Adrian Starzynski

Adrian Starzynski
September 18, 2023

eForms, Imaging, ON, Paid Downloads, Radiology, Southwestern Ontario, Ultrasound

London X-Ray Associates Ultrasound and Echocardiograms Requisition

London X-Ray Associates Ultrasound and Echocardiograms Requisition London, Ontario Includes one-touch submit & fax button. This requisition is for Ultrasound and Echocardiograms. See the other LXA requisitions for: “London X-Ray Associates General Diagnostic Imaging Requisition” and “London X-Ray Associates Obstetrical…

Adrian Starzynski
September 18, 2023

Bone Health, eForms, Imaging, ON, Paid Downloads, Radiology, Southwestern Ontario, Xray

London X-Ray Associates General Diagnostic Imaging Requisition

London X-Ray Associates General Diagnostic Imaging Requisition London, Ontario Includes one-touch submit & fax button. This requisition is for X-Ray, Bone Mineral Densitometry, and Digital Mammography services. See the other LXA requisitions for “London X-Ray Associates Ultrasound & Echocardiograms Requisition”…

Adrian Starzynski
September 18, 2023

eForms, Imaging, ON, Paid Downloads, Radiology, Southwestern Ontario

MRI Requisition South West LHIN

MRI Requisition for the South West LHIN (Ontario) region / SouthWest LHIN MRI Requisition Includes automatic signature. Created by Adrian Starzynski See: MRI Knee Appropriateness Checklist which is to be attached if requesting MRI of knee Code Copyright Adrian Starzynski

Adrian Starzynski
September 18, 2023

Cardiology, eForms, Imaging, ON, Paid Downloads, Radiology, Screening, Southwestern Ontario, Ultrasound, Xray

MyHealth Centre Requisition Southwestern Ontario

Latest version of MyHealth Centre Requisition for Southwestern Ontario (V01-29–/2021) Provides diagnostic imaging, ultrasound, x-ray, nuclear medicine, mammography, bone mineral density, cardiology, ECG, pulmonary testing, spirometry… services. The second page is just a list of locations, so it is set…

Adrian Starzynski
September 18, 2023

eForms, GTA, Imaging, ON, UHN - University Health Network, Ultrasound, Xray

UHN General Medical Imaging Request Form GTA Toronto

UHN General Medical Imaging Request Form GTA Toronto UHN (University Health Network), WCH (Women’s College Hospital), Sinai Health System, Toronto Requisition for Ultrasound, X-Ray, Breast Imaging, Nuclear Medicine. Created by Leo Pavone.