Providence Ambulance eOrders

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Entry ID163
eOrder Submission Date03/28/2024
eOrder Submission Time15:09 PM
Requester Information
Ordering FacilityProvidence St. Jude Plaza Radiation Oncology
Requester DepartmentRadiation Oncology
Requester Phone7144465632
Requester EmailEmail hidden; Javascript is required.
Service Needs Information
Service LevelEMT Basic Life Support
Trip TypeWait and Return
Bariatric Patient?No
Ambulance Transfer Reason(s)
  • In-patient inter-campus transfer.
Trip Schedule Information
Pickup Date03/29/2024
Response TypeScheduled Transport
Pickup Time11:10 AM
Appointment Time12:10 PM
Standing OrderNo
Pickup Location Information
Pickup LocationProvidence St. Jude Medical Center
Pickup Location Department/Unit Name4W
Pickup Location Patient Room/Bed No.ROOM 4429
Pickup Location Department Phone17149923000
Drop Off Location Information
Drop Off LocationProvidence St. Jude Plaza Radiation Oncology
Drop Off Receiving Department/Unit NameRADIATION ONCOLOGY SUITE 1500
Drop Off Receiving Department Phone7144465632
Drop Off Receiving Contact NameJUAN ANTHONY TORRES
Reimbursement Information
Patient Information
Patient NameJUAN GARCIA SERNA
Patient SexMale
Patient Date of Birth08/09/1945
Patient Age78
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
  • Other
Accompanying DocumentsPlease upload accompanying transfer documents.
Order Submission Certification
Signature
eOrder Submission Date03/28/2024