UHN Medical Imaging CT Request Form

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  • Create Date October 24, 2023
  • Last Updated February 4, 2024

UHN Medical Imaging CT Request Form

UHN Medical Imaging CT Request Form

Toronto UHN, Sinai Health System, Women's College Hospital

Includes faxing as well as automatic signature

Created by Adrian Starzynski

Code Copyright © 2024 Adrian Starzynski

There is an alternate version also attached "Alternate_UHN_Medical_Imaging_CT_Req.zip"

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.

The alternate version is protected by the GNU General Public License version 2 (GPLv2)

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