Get the free CB3 MRI SAFETY SCREENING FORM PARTICIPANT - psychology unl

Form CB3 MRI Safety Screening Form Participant Version7 Updated 08.20.14 CB3 MRI SAFETY SCREENING FORM PARTICIPANT Name (please print): For department use only: Date of MRI / / Date / / Appointment

How to fill out cb3 mri safety screening

Point by point guide on how to fill out CB3 MRI safety screening:

1. Start by carefully reading the instructions: Before filling out the CB3 MRI safety screening form, make sure you read and understand all the provided instructions. This will help you accurately complete the form and ensure your safety during the MRI procedure.
2. Provide your personal information: Begin by filling out the personal information section of the form. This typically includes your full name, date of birth, contact details, and any relevant identification numbers such as your patient ID or social security number.
3. Medical history and current conditions: The next section of the CB3 MRI safety screening form will ask about your medical history and any existing conditions. Provide accurate and detailed information about any past surgeries, chronic illnesses, allergies, or medications you are currently taking. This information helps the medical team evaluate whether it is safe for you to undergo an MRI.
4. Metal objects and implants: In this section, you will be asked about any metallic objects or implants in your body. It is crucial to disclose all relevant information, including pacemakers, defibrillators, surgical implants, prosthetic joints, metal fragments, or tattoos that contain metallic pigments. Certain metallic objects can interfere with the MRI procedure and may pose risks to your safety.
5. Claustrophobia or anxiety: If you struggle with claustrophobia or anxiety that could potentially affect your experience during an MRI, make sure to indicate this on the form. Medical staff can provide appropriate support and make necessary arrangements to ensure your comfort during the procedure.
6. Pregnancy or breastfeeding: Inform the medical team if you are pregnant or breastfeeding. While MRI is generally considered safe during pregnancy, there are specific precautions that need to be taken. Likewise, breastfeeding mothers may need to make special arrangements to prevent any potential harm to the baby.
7. Additional information: The CB3 MRI safety screening form may include additional sections or questions depending on the specific facility's requirements. Answer these sections honestly and accurately to provide a comprehensive overview of your health status and any potential risks or concerns that might affect the MRI procedure.

Who needs CB3 MRI safety screening?

CB3 MRI safety screening is necessary for anyone scheduled to undergo an MRI procedure. It is a crucial step to evaluate your medical history, current health conditions, and the presence of any metal objects or implants that could interfere with the MRI and pose risks to your safety. Whether you are a first-time MRI patient or have undergone multiple MRI scans in the past, completing the CB3 MRI safety screening form helps ensure your well-being and the success of the procedure.

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