Providence Ambulance eOrders

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Entry ID158
eOrder Submission Date03/25/2024
eOrder Submission Time15:21 PM
Requester Information
Ordering FacilityProvidence St. Jude Medical Center
TitleOther
Other TitleRadiation Therapist
Requester DepartmentSt Jude Radiation Oncology
Requester Phone7144465632
Requester EmailEmail hidden; Javascript is required.
Service Needs Information
Service LevelEMT Basic Life Support
Trip TypeOne-Way
Bariatric Patient?No
Ambulance Transfer Reason(s)
  • In-patient inter-campus transfer.
Trip Schedule Information
Pickup Date03/26/2024
Response TypeScheduled Transport
Pickup Time01:30 PM
Appointment Time02:30 PM
Standing OrderNo
Pickup Location Information
Pickup LocationProvidence St. Jude Medical Center
Pickup Location Department/Unit Name286
Pickup Location Patient Room/Bed No.286
Pickup Location Department Phone714 992-3000 ext: 7343
Drop Off Location Information
Drop Off LocationProvidence St. Jude Plaza Radiation Oncology
Drop Off Receiving Department/Unit Namesuite 1500
Drop Off Receiving Department Phone7144465632
Reimbursement Information
Patient Information
Patient NameBall Carroll
Medical Record No.20011521020
Patient SexFemale
Patient Date of Birth07/27/1941
Patient Age82
Spoken LanguageEnglish
Interpreter Required?No
Patient Medical Information
Isolation PrecautionNo
Medical Necessity Certification
Is Patient Bed-confined?No
Medical Needs During Transport
Required Equipment and Care
  • Oxygen
Accompanying DocumentsPlease upload accompanying transfer documents.
Order Submission Certification
Signature
eOrder Submission Date03/25/2024