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MAGNETIC RESONANCE (MR) PROCEDURE SCREENING FORM FOR PATIENTS Patient Name: Date: / / Age: Wt: 1. Have you had prior surgery or an operation (e.g., arthroscopy, endoscopy, etc.) or any kind? YES NO
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MRI screening formpdf is a form used for screening individuals before undergoing an MRI procedure.
Patients who are scheduled to undergo an MRI procedure are required to fill out and submit the MRI screening formpdf.
To fill out the MRI screening formpdf, patients need to provide information about their medical history, current medications, and any metal objects in their body.
The purpose of the MRI screening formpdf is to ensure the safety of patients by identifying any potential risks or contraindications before they undergo an MRI procedure.
Patients must report their medical history, current medications, allergies, and any metal objects or implants in their body on the MRI screening formpdf.
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