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MRI SCREENING QUESTIONNAIRE Patient Name: Age: Date of Birth: Height: Weight: Male: Female: Please describe current symptoms or problems you are experiencing (why are you having this exam): Do you
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How to fill out "Please describe current symptoms":

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Begin by carefully observing and noting down any physical sensations or abnormalities you may be experiencing. This can include pain, discomfort, fatigue, dizziness, or any other unusual sensations.
02
Next, contemplate the specific timing of these symptoms. Are they constant or intermittent? Do they occur at certain times of the day or in response to particular activities or triggers? It is essential to be as precise as possible in describing the timing.
03
Consider any factors that may exacerbate or alleviate your symptoms. For instance, does rest help reduce the symptoms? Are there specific actions or interventions that worsen the symptoms? Include these details in your description.
04
Assess the severity of your symptoms and attempt to rate them on a scale of 1-10, with 1 being mild and 10 being severe. This will provide valuable information in understanding the impact of the symptoms on your daily life and overall well-being.

Who needs "Please describe current symptoms":

01
Individuals seeking medical assistance and evaluation should fill out the "Please describe current symptoms" section. It helps healthcare professionals gain a comprehensive understanding of the patient's health condition.
02
Researchers conducting studies or clinical trials may ask participants to describe their current symptoms to assess treatment efficacy or measure disease progression.
03
Employers or insurance companies may require individuals to describe current symptoms when filing claims related to work-related injuries or illness.
Remember, adequately describing your current symptoms can significantly aid in accurate diagnosis and facilitate appropriate medical interventions.
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Please provide details of any physical or emotional symptoms you are currently experiencing.
Anyone who is experiencing symptoms and needs to report them to a healthcare provider.
You can fill out the symptoms by writing down any discomfort, pain, or abnormalities you are experiencing.
The purpose is to help healthcare providers understand your current health status and provide appropriate treatment.
You should report any details about the type, severity, duration, and frequency of your symptoms.
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