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M.R.I. SCAN INFORMATION SHEET Mod. M7.2/15 Rev. 1 Del 23/05/2007 The Magnetic Resonance Imaging technique involves the use of magnetic fields and radiofrequency waves, hence it is considered risks

How to fill out mri scan information sheet

How to fill out MRI scan information sheet:

1. Start by providing your personal information: Fill out your full name, date of birth, address, and contact details. This information is necessary for identification purposes and for sending your scan results to the correct recipient.
2. Medical history: Write down any relevant medical conditions, past surgeries, allergies, or medications you are currently taking. This information helps the radiologist better understand your health background and make appropriate recommendations for your scan.
3. Pregnancy status: If you are a female, indicate whether you are currently pregnant or suspect that you might be. It is important to inform the medical staff about this as an MRI scan may not be suitable during pregnancy.
4. Implants or medical devices: Disclose any implants, devices, or metal objects in your body, such as pacemakers, cochlear implants, or joint replacements. Some implants can interfere with the MRI scan or cause discomfort, so the medical staff needs to be aware of them.
5. Claustrophobia or anxiety: If you experience claustrophobia or anxiety in confined spaces, inform the medical staff beforehand. They can provide options like open MRI machines or sedation to help you feel more comfortable during the procedure.
6. Previous contrast reactions: Specify if you have had any previous allergic reactions or problems when receiving contrast agents for other medical procedures. This information helps the medical team determine the appropriate type of contrast agent to use, if necessary.
7. Follow instructions and sign: Read any additional instructions provided on the MRI scan information sheet carefully. It may include details on fasting requirements, medication intake, or dress code for the procedure. Once you have completed the form and understood the instructions, sign and date it.

Who needs MRI scan information sheet?

1. Patients undergoing an MRI scan: Anyone scheduled for an MRI scan will need to fill out the information sheet. This ensures that the medical staff has the necessary details to provide a safe and effective scanning experience.
2. Medical professionals conducting the scan: The MRI scan information sheet is essential for radiologists and technicians who perform the scan. It allows them to understand the patient's medical history, identify any potential risks or contraindications, and tailor the procedure accordingly.
3. Medical records and documentation: The completed information sheet serves as a record for the patient's medical files. It provides a comprehensive overview of the patient's background and helps ensure that accurate information is available for future reference or follow-up visits.

Remember, accuracy and honesty are crucial when filling out the MRI scan information sheet. Providing correct details ensures that the medical team can deliver the best possible care and avoid any potential complications during the scan.

For pdfFiller’s FAQs

What is mri scan information sheet?

MRI scan information sheet is a document that provides details about the patient's medical history, the reason for the MRI scan, and any relevant information for the healthcare provider.

Who is required to file mri scan information sheet?

The patient or their legal guardian is usually required to fill out the MRI scan information sheet before the appointment.

How to fill out mri scan information sheet?

The MRI scan information sheet can be filled out by providing accurate and detailed information about the patient's medical history, current symptoms, and any previous MRI scans.

What is the purpose of mri scan information sheet?

The purpose of the MRI scan information sheet is to help healthcare providers better understand the patient's condition and provide appropriate treatment.

What information must be reported on mri scan information sheet?

The MRI scan information sheet typically requires details such as the patient's name, date of birth, current symptoms, past medical history, and any allergies.

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