Get the free MRI PATIENT SCREENING FORM - bsantafeimagingbbcomb
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1640HospitalDrive,Santa Fe,NM87505 TEL:5059839350 FAX:5059860859 MRIPATIENTSCREENINGFORM PATIENTNAME DOB AGE HOMOPHONE WEIGHT CELLPHONE HEIGHT WORKSHOP REFERRINGPHYSICIAN EXAMORDERED DESCRIBEYOURPROBLEM&HOWLONGYOUHAVEHADIT
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How to fill out mri patient screening form
Who needs an MRI patient screening form?
01
Patients who are scheduled to undergo an MRI scan.
02
Medical professionals who conduct MRI scans.
How to fill out an MRI patient screening form:
01
Begin by providing your personal information such as your full name, date of birth, and contact details. This information is essential for proper identification and communication purposes.
02
Answer questions related to your medical history. It is crucial to disclose any known allergies, previous surgeries, or medical conditions you may have. This information can help the medical professionals ensure your safety throughout the MRI procedure.
03
Indicate any metal or electronic implants or devices you may have. MRI machines use strong magnets, so it is important to disclose any metal objects in or on your body. Examples include pacemakers, cochlear implants, braces, or any metallic fragments.
04
Answer questions concerning your state of health on the day of the MRI. These questions may inquire about recent illnesses, pregnancy, or symptoms like claustrophobia. Honest and accurate responses are important for your safety and to determine if any additional precautions are needed.
05
Follow any additional instructions provided on the form. This may include guidelines on fasting, medication restrictions, or specific preparation steps to ensure a successful MRI scan.
06
Review the completed form for accuracy and completeness before submitting it. Inaccurate or incomplete information may affect the evaluation and safety of the MRI procedure.
Remember, the MRI patient screening form serves as a vital tool for medical professionals to determine the suitability and safety of undergoing an MRI scan. Providing accurate information on the form is crucial, as it helps ensure your well-being during the procedure.
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What is mri patient screening form?
MRI patient screening form is a document that collects relevant information about a patient prior to undergoing an MRI scan.
Who is required to file mri patient screening form?
Patients scheduled to undergo an MRI scan are required to fill out the MRI patient screening form.
How to fill out mri patient screening form?
Patients can fill out the MRI patient screening form by providing accurate information about their medical history, current medications, and any other relevant details.
What is the purpose of mri patient screening form?
The purpose of the MRI patient screening form is to ensure the safety of patients during MRI scans by screening for any potential risks or contraindications.
What information must be reported on mri patient screening form?
Information such as medical history, current medications, allergies, prior surgeries, and any metal implants or devices must be reported on the MRI patient screening form.
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