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Chilliwack Mammography Referral eForm 2017

From David Page - Here is the final version of the mammogram form- ( Chilliwack specific ) - the difference only being in the image with some customisation for the Chilliwack Breast Clinic. I looked at the Generic BC Mammogram form- has all the same fields but really badly laid out. The main benefit is the field checking which hopefully reduces delays from rejections (something that the Xray department said was happening a lot). David From David Page: -------- Breast imaging requisition created through the Chilliwack Radiology Shared Care Project between the GPs and Radiologists and Radiology clerical staff ------ The form should be usable by everyone in Fraser Health but you may need to negotiate some of the short cuts: 1) No need for date of imaging if done in BCl- the staff pull up the latest imaging reqs anyway and dates are on them. Need to specify the grid the imaging was done on. 2) Can just specifiy “followup as per radiologist” as they have the previous mammo anyway 3) Can just specify “followup as per attached” if mammogram done out of BC and attach the req 4) No need for LMP just put “Premenopausal” ------ It has field checking to make sure form is complete and it pulls information across to the next time you open the imaging form in that patient like family history and biopsy history. ------- David

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