Providence Ambulance eOrders

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Entry ID167
eOrder Submission Date04/08/2024
eOrder Submission Time11:59 AM
Requester Information
Ordering FacilityProvidence St. Jude Plaza Radiation Oncology
TitleOther
Other TitleRadiation Therapist
Requester DepartmentRadiation Oncology Suite 1500
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 Date04/09/2024
Response TypeScheduled Transport
Pickup Time09:30 AM
Appointment Time10:30 AM
Standing OrderNo
Pickup Location Information
Pickup LocationProvidence St. Jude Medical Center
Pickup Location Department/Unit Name5 NWT
Pickup Location Patient Room/Bed No.5113-01
Pickup Location Department Phone7144467510
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
Reimbursement Information
Patient Information
Patient NameSteve Lee
Patient SexMale
Patient Date of Birth04/18/1943
Patient Age80
Spoken LanguageKOREAN
Interpreter Required?Yes
Patient Medical Information
Isolation PrecautionNo
Medical Necessity Certification
Is Patient Bed-confined?Yes
Medical Needs During Transport
Required Equipment and Care
  • Other
Accompanying DocumentsPlease upload accompanying transfer documents.
Order Submission Certification
Signature
eOrder Submission Date04/08/2024