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MRI Screening Form Patient Name: DOB: Date: Weight: Yes No Cardiac Pacemaker or Implanted Cardiac Defibrillator Internal electrodes, wires, retained pacemaker leads Brain Aneurysm Clips/ Brain Surgery
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What is mri screening form?
MRI screening form is a document used to gather information about individuals before they undergo an MRI scan.
Who is required to file mri screening form?
Anyone who is scheduled to undergo an MRI scan is required to fill out the MRI screening form.
How to fill out mri screening form?
The MRI screening form can be filled out by providing personal information, medical history, and any relevant details about the MRI procedure.
What is the purpose of mri screening form?
The purpose of the MRI screening form is to ensure the safety of the individual undergoing the MRI scan by identifying any potential risks or contraindications.
What information must be reported on mri screening form?
The MRI screening form typically requires information such as medical history, current medications, allergies, and any implanted devices.
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