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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
Click to go to the section dedicated to forms.
Administration
Click to go to the section dedicated to forms.
Digestive endoscopy
Click to go to the section dedicated to forms.
Clinical Analysis Laboratory
Click to go to the section dedicated to forms.
Sports medicine
Click to go to the section dedicated to forms.
Clinic
Click to go to the section dedicated to forms.
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.
Data form for multilingual reservations
Click to consult and download the multilingual booking form.
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.
COVID Test Differences
Click to consult and download the documentation relating to the differences in COVID tests.
Sports medicine
Sports Medical Visit - Preparation Information
Click to consult and download the documentation for useful information to know about the sports medical visit.
Difference between fitness for competitive and non-competitive sports
Click to consult and download the documentation relating to the difference between fitness for competitive and non-competitive sports.
Consent to the processing of personal data
Click to consult and download the documentation relating to the consent of personal data.
Informed consent - Cycle ergometer
Click to consult and download the documentation relating to the informed consent of the cycle ergometer test.
Diabetological Certification - Certification Model
Click to consult and download the diabetological certification model to be delivered to the specialist in sports medicine.
Periodicity of visits
Click to consult and download the documentation relating to the frequency of sports doctor visits.
Sport fitness questionnaire
Click to consult and download the documentation relating to the questionnaire for the assessment of specific fitness for sport.
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.
Athlete personal card
Click to consult and download the documentation relating to the athlete’s personal file.
Covid Factsheet - Sports Medicine
Click to consult and download the documentation relating to the anamnesis for the prevention of infection by Sars-Cov-2 infection.
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.