MODULES

In this section you will find all the downloadable modules, divided by the various departments, and the rates of the Villa Salus Hospital

Forms

Choose the department of your interest to go directly to the dedicated section.

Reception

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Administration

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Digestive endoscopy

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Clinical Analysis Laboratory

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Clinical Analysis Laboratory

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Sports medicine

Click to go to the section dedicated to forms.

Clinic

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Radiodiagnostics

Click to go to the section dedicated to forms.

Schedules

Select the schedule that interests you.

Outpatient activity

Freelance schedule

Outpatient activity

Private schedule

Analysis laboratory

Private schedule

Radiodiagnostics

Private schedule – Magnetic Resonance

Reception

Collection of biological samples

Click to view and download the document containing information on the collection of biological samples.

Administration

Medical records request

Click to see and download the forms request to copy the clinical documentation, with delegation.

P.R.O. Report Sheet

Click to see and download the communication with the Public Relations Office.

Digestive endoscopy

Colonscopy - Preparation Information and Informed Consent

Click to consult and download the documentation for useful information to know to prepare for the intervention and the informed Consent form.

Colonscopy - Deep Sedation: Information, Informed Consent and Anamnestic Survey

Click to consult and download the documentation for useful information to know to prepare for the intervention, the Informed Consent form and the anamnestic survey.

Colonscopy - Conscious Sedation: Information and Informed Consent

Click to consult and download the documentation for useful information to know to prepare for the intervention and the informed Consent form.

Gastroscopy - Preparation Information and Informed Consent

Click to consult and download the documentation for useful information to know to prepare for the intervention and the informed Consent form.

Clinical Analysis Laboratory

HP Breath Test - Preparation Information and Informed Consent

Click to consult and download the documentation for useful information to know about the breath test for Helicobacter Pylori in the gastric mucosa and the informed Consent module.

Food intolerance test list

Click to see and download the food intolerance test list.

Breath Test H2 Lachitosis and Glucose - Information and Informed Consent

Click to consult and download the documentation for useful information to know about the breath test and the informed Consensus form.

 

PEP Test - Exam Information

Click to view and download the PEP Test information documentation.

Collecting biological samples - About how to collect them

Click to consult and download the documentation related to the information related to the collection of biological materials analytical purpose and patient preparation.

Material Delivery Isto/Cytopathological - Delivery Form

Click to consult and download the form to be filled out in order to request the advice, in another institution, of the histopathological material.

 

Blood withdrawal at home - Service information

Click to see and download the documentation for information about the blood collection service at home.

 

PT Coagulation Test (INR) - Exam Information

Click to view and download the documentation for PT clotting test (INR) information.

Sports medicine

Sports Medical Visit - Preparation Information

Click to consult and download the documentation for useful information to know about the sports medical visit.

Diabetological Certification - Certification Model

Click to consult and download the diabetological certification model to be delivered to the specialist in sports medicine.

Request medical examination by sports company - Model to request the visit

Are you a sports club? Click to consult and download the form to request a sports medical examination for the athlete.

Clinic

Electroencephalogram - Preparation Information and Informed Consent

Click to consult and download the documentation for useful information to know about the examination and informed consent.

Electromyography - Exam Information

Click to view and download the documentation for useful information to know about the exam.

PAP Test - Exam Information

Click to consult and download the documentation related to the cervic-vaginal cytological examination (PAP Test).

 

Diagnostic Hythroscopy - Preparation Information and Informed Consent

Click to consult and download the documentation for useful information to know about the examination and informed consent.

Radiodiagnostics

Abdomen - Preparing Information

Click to consult and download the documentation for useful information to know about the X-ray examination of the abdomen for colic (calculation research).

Double Contrast Opaque Climate - Preparation Information and Informed Consent

Click to consult and download the documentation for useful information to know about the radiological study of the Colon-Sigma-Retto and informed consent.

VIRTUAL COLONSCOPY (Colon TAC) - Information on Preparation

Click to consult and download the documentation for useful information to know about the examination carried out with virtual colonoscopy and informed consent.

VIRTUAL COLONSCOPY (Colon TAC) - Informed Consent

Click to consult and download the documentation for useful information to know about the examination carried out with virtual colonoscopy and informed consent.

Defecography - Preparation Information and Informed Consent

Click to consult and download the documentation for useful information to know about the examination and informed consent.

Contrast Ultrasound - Preparation Information and Informed Consent

Click to consult and download the documentation for useful information to know about the examination and informed consent.

Magnetic Resonance - Informed Consent and Anamnestic Survey

Click to consult and download the documentation for useful information to know about the exam, informed consent and the anamnestic survey.

Magnetic resonance with contrast media - Informed consent

Click to consult and download the documentation for useful information to know about the examination and informed consent to intravenous injection of paramagnetic contrast medium.

Hyterosalpingography - Preparation Information, Informed Consent and Booking Mode

Click to view and download the documentation for useful information to know about the exam, informed consent and how to book.

CD radiological images - Instructions for use

Click to see and download the documentation for instructions on using the radiological image CD.

Academy Ultrasounds - Preparation Information

Click to consult and download the documentation for useful information to know to carry out the exam.

Renal Insufficiency by Iodato MDC - Prevention Information

Click to review and download the documentation for recommendations to prevent kidney failure following the administration of M.D.C. Iodato.

Preparing for examinations with MDC in case of Allergy - Prevention Information

Click to review and download the documentation for recommendations to reduce and/or prevent allergic reactions following the administration of M.D.C.

CONTRAST CT - Preparation Information and Informed Consent

Click to consult and download the documentation for useful information to know about the examination and informed consent.