Imaging
All imaging related eForms goes here
- Bone Density Requisition
- Bone Density Requisition - Based on the BC standard outpatient bone density requisition
- CT scan - IV contrast related forms
- Some forms used to satisfy the radiology department's concerns about the use of IV contrast in patients with renal dysfunction.
- Diagnostic Imaging Requisition - Hamilton, Ont
- Imaging Requisition
- Based on the Fraser Health Radiology Department Req. You'll need to upload both the html file and the image file.
- MRI - FHA
- MRI Req based on the Fraser Health Authority Req
- Nuclear Medicine - FHA
- PET Scan Requisition - UBC
- Valley Imaging Requisition
- Imaging requisition for the private x-ray clinic in the Fraser Valley. Has a shortcut menu on the side to quickly fill in the body part to be x-rayed and related clinical indication.
- VCH Imaging Requisition
- This new requisition is used to access almost all hospital-based imaging services in the Vancouver Coastal Health authority. I've again incorporated drop down boxes for locations and phone numbers. Please inform me if there are inaccuracies, and I will correct. If any one can get an "original" pdf file of the form, I will use that as the background.
- Bowel Preparation Instructions
- New preparations are now recommended for patients with renal impairment. You will need to upload the html files to the e-form library, and the png files to the image library. If you have already used 2-page e-forms, you should have the print1.css and print2.css in the image library already. Otherwise, you will need to upload these as well.
- VCH Medical Imaging Requisition - updated
- Updated with pdf backgrounds. The 2nd page (locations) is more legible. The older requisition also works. You will need to upload the new png files for this html. If you have used the older version, do not delete the previous png file from your library.
- BCWH Mammography and Breast Health Referral Updated Dec 2011
- Breast Imaging - BC Women's Hospital
- BCWH will only accept their specific referral form. This was developed by Dr. J. Robertson.
- BC Standard Outpatient Mammography Form
- Quoting John Yap: This is the Standard outpatient mammogram form, as per BCMA/Gov't. A new Oscar user in Burnaby asked me to add some of the non-hospital sites, so the drop-down menu was incorporated. It's been updated such that choosing a second site, if the first is selected in error, does not add to the text. Simply removing the "+" from the "+=" function does wonders! I had the form completed then decided to check for any updates on the background. Doh - there was one in '09!! Only a couple new checkboxes needed, and there's the mandatory PIPA disclaimer on the bottom. JohnY
- Generic Bilingual imaging requisition
- pure HTML. Created by Earl Wertheimer.
