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WA Bellingham Advanced Medical Imaging Consent for MRI Imaging & Contrast Administration During Pregnancy 2018-2025 free printable template

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CONSENT FOR MRI IMAGING & CONTRAST ADMINISTRATION DURING PREGNANCY Patient Name: Date of Birth: / / Procedure to be Performed: Your medical provider / doctor has determined that it is necessary for
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How to fill out WA Bellingham Advanced Medical Imaging Consent

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How to fill out WA Bellingham Advanced Medical Imaging Consent for MRI

01
Start by obtaining the WA Bellingham Advanced Medical Imaging Consent for MRI form from the facility or their website.
02
Read the instructions carefully to understand the purpose and implications of the consent.
03
Fill in your personal information at the top of the form, including your name, date of birth, and any relevant medical history.
04
Review the sections outlining the procedure, potential risks, and benefits of the MRI scan.
05
Sign and date the consent form where indicated, confirming that you understand the information provided and agree to proceed.
06
If necessary, have a guardian or advocate sign the form if you are a minor or unable to consent for yourself.

Who needs WA Bellingham Advanced Medical Imaging Consent for MRI?

01
Anyone who is scheduled to undergo an MRI at WA Bellingham Advanced Medical Imaging.
02
Patients who require an MRI as part of their medical evaluation or treatment plan.
03
Individuals who do not have a valid consent form signed prior to their MRI appointment.
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WA Bellingham Advanced Medical Imaging Consent for MRI is a formal document that patients sign to give consent for an MRI procedure. It ensures that patients are informed about the procedure, its benefits, potential risks, and alternatives.
Patients who are scheduled to undergo an MRI at WA Bellingham Advanced Medical Imaging need to file this consent form.
To fill out the consent form, patients should provide their personal information, review the procedure details, acknowledge understanding of the risks and benefits, and then sign and date the form.
The purpose of the consent form is to ensure that patients understand the nature of the MRI procedure, the associated risks, and their rights, thus protecting both the patient's and the provider's legal interests.
The consent form should include the patient's personal details, a description of the MRI procedure, a list of potential risks, benefits, any alternative options, and a statement of consent with the patient's signature.
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