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CARDIOVASCULAR MRI PROCEDURE REQUEST Patient Name: MAN: DOB: Sex: Age: Height: Weight: If patient has cardiac pacemaker, defibrillator, ICD, aneurysm clips, or metallic foreign body please notify
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How to fill out cardiovascular mri procedure request

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How to fill out cardiovascular mri procedure request

01
Obtain the necessary referral or prescription from a healthcare provider.
02
Contact the radiology department to schedule an appointment for the cardiovascular MRI procedure.
03
Prior to the appointment, gather and bring any relevant medical records or imaging studies.
04
Follow any fasting instructions provided by the healthcare provider or radiology department.
05
Arrive at the designated location at the scheduled time.
06
Provide the necessary personal and insurance information upon arrival.
07
Change into a gown or other appropriate attire as instructed.
08
During the procedure, lie still and follow any breathing or movement instructions given by the technician.
09
After the procedure, wait for any necessary post-procedure instructions or results from the healthcare provider.
10
Follow up with the healthcare provider for further guidance or treatment based on the results of the cardiovascular MRI.

Who needs cardiovascular mri procedure request?

01
Individuals who are suspected or have been diagnosed with cardiovascular conditions may require a cardiovascular MRI procedure request.
02
This may include individuals with heart disease, heart failure, congenital heart defects, or suspected heart abnormalities.
03
Additionally, individuals who are at high risk for cardiovascular disease or who require monitoring of heart function may also need a cardiovascular MRI procedure request.
04
It is important to consult with a healthcare provider to determine if a cardiovascular MRI is necessary for a specific individual.
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The cardiovascular MRI procedure request is a form that must be submitted to request a magnetic resonance imaging (MRI) scan of the heart and blood vessels for diagnostic purposes.
Healthcare providers such as doctors, cardiologists, or other medical professionals are required to file the cardiovascular MRI procedure request on behalf of the patient.
The healthcare provider must complete the form with the patient's personal information, relevant medical history, reason for the MRI scan, and any other pertinent details.
The purpose of the cardiovascular MRI procedure request is to obtain detailed images of the heart and blood vessels to aid in the diagnosis of cardiovascular conditions such as heart disease, congenital heart defects, or abnormalities.
The cardiovascular MRI procedure request must include the patient's name, date of birth, medical history, reason for the MRI scan, referring physician, insurance information, and any relevant diagnostic tests.
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