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PARTICIPANTS WITH ANY HISTORY OF IMPLANTS MUST BE APPROVED BY THE MRI SAFETY OFFICER BEFORE A MRI SCAN MAY BE PERFORMED WITHOUT EXCEPTION.UC DAVIS IMAGING RESEARCH CENTER PREMRI SCREENING FORM Date:

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How to fill out pre-mri screening form

01

Read the pre-MRI screening form carefully and thoroughly.

02

Complete all sections of the form accurately, providing detailed information as requested.

03

Ensure that all medical history, current medications, and any previous MRI experiences are disclosed on the form.

04

If you have any questions or concerns about the form, consult with the healthcare provider overseeing your MRI appointment.

Who needs pre-mri screening form?

01

Individuals who are scheduled to undergo an MRI procedure are typically required to fill out a pre-MRI screening form.

02

This form is necessary to ensure the safety and well-being of the individual during the MRI scan, as well as to help healthcare providers assess any potential risks or contraindications.

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What is pre-mri screening form?

The pre-MRI screening form is a document that patients fill out before undergoing an MRI scan to ensure their safety by identifying any potential hazards related to the procedure.

Who is required to file pre-mri screening form?

Patients scheduled for an MRI procedure are required to file the pre-MRI screening form.

How to fill out pre-mri screening form?

To fill out the pre-MRI screening form, patients should provide accurate information regarding their medical history, any implanted devices, allergies, and additional relevant health information.

What is the purpose of pre-mri screening form?

The purpose of the pre-MRI screening form is to ensure the safety of the patient by identifying any conditions or factors that may contraindicate the MRI procedure.

What information must be reported on pre-mri screening form?

Information that must be reported includes personal medical history, current medications, any implanted electronic devices, metal fragments in the body, and allergies.

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