Cushing Memorial Hospital Leavenworth, KS 66048 Radiology Scheduling To schedule call (913) 684-1156/1155 To schedule via fax: (913) 684-1236
Home Phone: _____________ Alternate: ______________ Special Instructions:
Primary Care Physician: Insurance Type Ordering Physician (print): Ordering Physician (signature): ULTRASOUND HEAD X-Ray
o Joint – Specify RT, LT, or Bilateral
CHEST X-Ray EXTREMITY ABDOMEN X-Ray NUCLEAR MEDICINE CT SCAN: IVCONTRAST YES NO GASTROINTESTINAL/GU ARTHROGRAM With MRI BONE DENSITY STUDY MAMMOGRAPHY Unlisted Exam ________________________________ FOR SCHEDULERS ONLY: Appointment Date: _____________ Time: __________ Attempts made to contact patient: _________ Patient Label:
Page 1 of 2 CMH-XR-1402 (Rev. 11/12/09)
Cushing Memorial Hospital Leavenworth, KS 66048 Radiology Scheduling
Important Information Regarding Your Examination: • If you are on any medications that are necessary to take on a daily basis, please do not withhold these medications without checking with our technologists. If you take glucophage, metformin, glucovance, metaglip, or advandamet please alert our office at the time of scheduling. • If you have any allergies to iodine, other medications, or have asthma, please contact us prior to your examination. • If there is any possibility you might be pregnant, please let us know when scheduling. • If you have any questions regarding your examination, please contact our office. If for any reason you cannot make your scheduled appointment, please call to reschedule at 913-684-1156. Examination Preparation Instructions: UPPER GI SERIES: Do not eat or drink anything (not even water) after midnight the day of your examination. BARIUM ENEMA: You must pick up a LO-SO prep kit in the radiology department two days prior to your study. Follow the 24-hour prep instructions in the kit. IVP: You must pick up a LO-SO prep kit in the radiology department two days prior to your study. Follow the 24- hour prep instructions. Drink lots of liquids. Do not eat or drink anything four hours prior to your test. Absolutely no dairy products. SMALL BOWEL: Nothing to eat or drink after midnight. MAMMOGRAM: No body powder, lotions, or deodorant prior to exam. Please bring prior mammograms with you to your scheduled appointment. If this is not possible, you will need to provide the information needed to obtain these studies for comparison. ULTRASOUNDS US ABDOMEN/GALLBLADDER: Do not eat or drink anything after midnight until after your examination is completed. PELVIS/Obstetrical US: One hour prior to examination time, you need to drink 32 oz. of fluid (water or tea) to fill your bladder. Do not urinate before your examination is completed. Please avoid carbonated beverages. ALL MRIs: Please alert scheduler at time of scheduling if you have a pacemaker, any implants, implantable pumps, vena cava filters, or metal in the eyes. Please leave all jewelry and valuables at home. MRCP: Nothing to eat or drink 12 hours prior to your appointment. MRI CHILDREN: Children may have nothing to eat or drink four hours prior to the appointment time. CT HEAD, NECK IAC: Nothing to eat or drink four hours prior to your appointment. CT ABDOMEN AND PELVIS: In most cases once you arrive, you will be expected to drink oral contrast over a one or two hour period before the scanning begins, depending upon the area to be examined. Oral contrast can also be picked up prior to your appointment date and drank at home. a.m. appointments: Nothing to eat or drink after midnight the evening before your examination. p.m. appointments: Nothing to eat or drink four to six hours prior to your appointment time. CT ORBITS: Nothing to eat or drink four to six hours prior to your appointment time. CT CHEST: Nothing to eat or drink four hours prior to appointment time. Be sure to bring any previous chest X-rays with you to your appointment. CT ANGIOGRAPHY: Do not eat or drink four hours prior. Patient Label:
Page 2 of 2 CMH-XR-1402 (Rev. 11/12/09)
Phytotherapie Special Unbekannte Hamamelis-Anwendung Hilfreich gegen Glatze & Co. WALLISELLEN ZH – Seit Jahrhunderten wird mit verschiedensten Mittelchen und Tinkturen versucht, kahle Kopfhaut neu zu beleben. Damit auf bereits kahle Stellen wieder Haare wachsen, hilft aber oftmals nur noch eine Haar- transplantation. Doch was ist der Stellenwert von Hamamelis? nic
Rapid Communication Prevalence of clopidogrel non-responders among patientswith stable angina pectoris scheduled for elective coronarystent placementIris Müller, Felicitas Besta, Christian Schulz, Steffen Massberg, Albert Schönig, Meinrad GawazDeutsches Herzzentrum und 1. Medizinische Klinik, Klinikum rechts der Isar,Technische Universität München, Munich, Germany Summary Dual antiplatel