Medical Imaging CT Request Form for Sinai Health System, UHN and WHC 2024

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  • Create Date February 4, 2024
  • Last Updated February 8, 2024

Medical Imaging CT Request Form for Sinai Health System, UHN and WHC 2024

CT requisition for Sinai Health System, UHN and WHC. Will pull Serum Creatinine, eGFR, and date from the patient's chart if it is present and they have been mapped. Checking yes to renal failure or diabetes will run a script to check that the lab values have been filled out and if they are less than 90 days old. Box to click "No" to all the screening questions. Also pulls patient's weight and LMP if these are available. You can click to circle "kg" or "lbs". For prescription, you can click to copy and then click the link to go to the prescription module and paste it.

This eForm is protected by the GNU General Public License version 2 (GPLv2)

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