ABSTRACT
The x-ray request form is an essential tool for communicating patient data and clinical indication from the referring physicians to radiologic departments and reduction of unnecessary radiation dose to the patient. This study aimed to evaluate the applied x-ray request form formula and to compare between the applied and standard request forms in different radiology departments. Numbers of elements of x-ray request form to be evaluated were assessed and questionnaire forms for technologist and physicians were distributed and data were analyzed using simple statistical method [percentage]. The results of the evaluation of the applied x-ray request form filling elements including [patient full name, age, sex, history, condition, clinical indication, LMP, date of the examination previous x-ray exams, Physician name and clearness of requested exam] were found to be 80%, 60%, 60%, 30%, 30%, 100%, 100% respectively. The total results filling of evaluation of all patient information of 50 x-ray request forms were 50.67%, 26.18%, 28%, 21.09%, 18.18%, 55.9% and 60.03 respectively. This study concluded that providing patients data and clinical indication on the x-ray request form is of vital importance regarding the answers of technologists and physicians in the questionnaire. Regarding to the result it showed that the method of filling patient information in x-ray request form by the referring physicians in addition to the formula of x-ray request form that were applied in Khartoum state hospitals should be reviewed