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Indication Radiology Standard Order Sub University Hospital Cologne

- 3/12/17 - 1 form, 1 itemgroup, 5 items, 1 language
Itemgroup: radiology standard order
Hospital Routine Documentation Subform at the University Hospital Cologne. Original Form name: Indikation RIS STD Sub

HW Main RIS University Hospital Cologne

- 3/12/17 - 1 form, 3 itemgroups, 92 items, 2 languages
Itemgroups: subform before order block, subform after order block, workflow
Hospital Routine Documentation Subform at the University Hospital Cologne. Original Form name: HW Haupt RIS

Indication Review Radiology Standard Standard Order University Hospital Cologne

- 3/19/17 - 1 form, 1 itemgroup, 23 items, 1 language
Itemgroup: Indication Review Radiology Standard Order
Hospital Routine Documentation Subform at the University Hospital Cologne. Original Form name: Indikationsprüfung RIS

Radiology procedure, University Hospital Cologne

- 4/29/17 - 1 form, 1 itemgroup, 17 items, 1 language
Itemgroup: Diagnostic/therapeutic radiology
Hospital Routine Documentation Subform at the University Hospital Cologne. Original Form name: Datenerfassung_Strahlen

Angiography request, University Hospital Cologne

- 4/16/17 - 1 form, 2 itemgroups, 25 items, 1 language
Itemgroups: RIS Request, Angiography Request
Hospital Routine Documentation Subform at the University Hospital Cologne. Original Form name: Angiograph_Anford

SpezifischeDiagnosen MS University Hospital Muenster (UKM) Subform

- 9/20/21 - 1 form, 1 itemgroup, 23 items, 1 language
Itemgroup: Diagnosen
Hospital Routine Documentation Subform at the University Hospital Muenster. Original Form name: SpezifischeDiagnosen.

Hematology/ Oncology request form University Hospital Cologne

- 9/17/21 - 1 form, 5 itemgroups, 73 items, 1 language
Itemgroups: patient information, laboratory procedure requested, radiology request, other examination, nursing medication request
Hospital Routine Documentation Subform at the University Hospital Cologne. Original Form name: HO-Anforderungsbogen

Hematology/ Oncology request elaboration form University Hospital Cologne

- 9/17/21 - 1 form, 4 itemgroups, 74 items, 1 language
Itemgroups: patient information, laboratory procedure requested, radiology request, other examination
Hospital Routine Documentation Subform at the University Hospital Cologne. Original Form name: HO-Ausarbeitungsbogen

Hematology/ Oncology execution form University Hospital Cologne - Hematology/ Oncology execution elaboration form University Hospital Cologne

- 9/17/21 - 1 form, 4 itemgroups, 75 items, 1 language
Itemgroups: patient information, laboratory procedure executed, radiologic examination execution, other examination
Hospital Routine Documentation Subform at the University Hospital Cologne. Original Form name: HO-Durchführungsbogen

KBV Request form laboratory services Template 10A

- 9/6/17 - 1 form, 8 itemgroups, 82 items, 1 language
Itemgroups: Header, Request form, EDTA Blood, Citrat, Serum whole blood, Glucose, Urine, Other
Muster 10A - Anforderungsschein für Laboratoriumsuntersuchungen bei Laborgemeinschaften Freigabe: 01.09.2014) - 10.2014, Formulare für die vertragsärztliche Versorgung Freigabe durch Dezernat 4 - Ärztliche Leistungen und Versorgungsstruktur Geschäftsbereich Sicherstellung und Versorgungsstruktur Abteilung Sicherstellung Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Quelle: http://www.kbv.de/html/formulare.php Forms for contract medical care Released by Department 4 - Medical treatment and structure of supply, division ensurance and structure of supply, department ensurance Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Source: http://www.kbv.de/html/formulare.php

KBV Prescription of laboratory services Template 10

- 9/6/17 - 1 form, 4 itemgroups, 33 items, 1 language
Itemgroups: Header, Laboratory service, Medical information, Footer
Muster 10 - Überweisungsschein für Laboratoriumsuntersuchungen als Auftragsleistung (Freigabe: 01.09.2014) - 10.2014, Formulare für die vertragsärztliche Versorgung Freigabe durch Dezernat 4 - Ärztliche Leistungen und Versorgungsstruktur Geschäftsbereich Sicherstellung und Versorgungsstruktur Abteilung Sicherstellung Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Quelle: http://www.kbv.de/html/formulare.php Forms for contract medical care Released by Department 4 - Medical treatment and structure of supply, division ensurance and structure of supply, department ensurance Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Source: http://www.kbv.de/html/formulare.php

KBV Referral to investigate somatic causes before starting psychotherapy Template 7

- 9/6/17 - 1 form, 2 itemgroups, 14 items, 1 language
Itemgroups: Header, Medical information
Muster 7 - Überweisung vor Aufnahme einer Psychotherapie zur Abklärung somatischer Ursachen (Freigabe: 01.09.2014) - 10.2014, Formulare für die vertragsärztliche Versorgung Freigabe durch Dezernat 4 - Ärztliche Leistungen und Versorgungsstruktur Geschäftsbereich Sicherstellung und Versorgungsstruktur Abteilung Sicherstellung Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Quelle: http://www.kbv.de/html/formulare.php Forms for contract medical care Released by Department 4 - Medical treatment and structure of supply, division ensurance and structure of supply, department ensurance Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Source: http://www.kbv.de/html/formulare.php

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