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WAKE FOREST SCHOOL OF MEDICINE Name: Translational Imaging MRI Patient Safety Screening Form Date of Birth: Study: The MR scanner contains a very strong magnet. Before you are allowed to enter the
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How to fill out mri safety screening form

How to fill out mri safety screening form
01
Read the instructions provided on the MRI safety screening form.
02
Fill out your personal information, including your full name, date of birth, and contact details.
03
Answer the questions on the form accurately and honestly.
04
Provide information about any medical conditions, previous surgeries, or implanted devices you may have.
05
Indicate any allergies or adverse reactions you have experienced in the past.
06
Note down any medications or supplements you are currently taking.
07
Include information about any metal objects or implants in your body.
08
Sign and date the form to certify that the information provided is true and complete.
Who needs mri safety screening form?
01
Anyone who is scheduled for an MRI (Magnetic Resonance Imaging) scan needs to fill out an MRI safety screening form.
02
It is a standard procedure to ensure the safety of individuals during the MRI scan.
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What is mri safety screening form?
MRI safety screening form is a document that collects information about a patient's medical history, implants, and other factors that may affect their safety during an MRI procedure.
Who is required to file mri safety screening form?
Patients who are scheduled to undergo an MRI procedure are required to fill out and submit the MRI safety screening form.
How to fill out mri safety screening form?
Patients can fill out the MRI safety screening form by providing accurate information about their medical history, implants, allergies, and any other relevant details.
What is the purpose of mri safety screening form?
The purpose of the MRI safety screening form is to ensure the safety of patients during MRI procedures by identifying any potential risks or contraindications.
What information must be reported on mri safety screening form?
Information such as medical history, implants, allergies, prior surgeries, and any other relevant medical conditions must be reported on the MRI safety screening form.
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