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 Medical Imaging Provider Referral Forms and Instructions 2018-2023

Medical Imaging Provider Referral Forms and Instructions 2018-2023

Use a north york general hospital requisition 2018 template to make your document workflow more streamlined.

** Myocardial Perfusion Imaging ** with Exercise Stress (continue on meds AMBULATORY MONITORING: Holter Monitor Recording 72 Hour 14 days 24 Hour N) with Pharmacological Stress ( Persantine® DOBUTamine) 48 Hour Radionuclide Angiogram (Rest MUGA) 30 days Ambulatory Blood Pressure Monitor ($64 fee) Myocardial Viability Imaging (Rest Thallium) ECHOCARDIOGRAPHY: (18 years of age or older) Echocardiogram Echo with Contrast Echo with Saline (Bubble Study) For referral by Cardiologists...
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