Generic Diagnostic Imaging Requisition

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  • Create Date January 5, 2022
  • Last Updated March 17, 2022

Generic Diagnostic Imaging Requisition

Created by Adrian Starzynski. A simple generic diagnostic imaging requisition for Ontario although it can easily be modified for BC (just remove the notice relevant only to ON from the bottom).

NOTE: In order for ordering physician's signature to be displayed, a signature image file is necessary.

Attached Files

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Generic244Diagnostic244Imaging244Requisition.zipDownload