VIHA Medical Imaging Requisition

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  • File Size 808.09 KB
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  • Create Date June 7, 2023
  • Last Updated June 6, 2023

VIHA Medical Imaging Requisition

This eFORM was requested by Shellbourne Medical. The original background was circa 2007, and this at least has a 2019 background.  It appears to cover all imaging modalities including breast studies.

OSCAR BC was asked to add the drawing function for the breast imaging area. The rest was created by the Shellbourne Clinic using the eFORM generator.

Warning: the wet signature may not fax properly.

Attached Files and Latest Versions

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VIHA_Medical_Imaging_V1_Jun6_2023.zipDownload