Get Mri Procedure Screening Form - Novant Health - Novanthealth
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How to use or fill out the MRI Procedure Screening Form - Novant Health - Novanthealth online
Filling out the MRI Procedure Screening Form is essential to ensure a safe and efficient MRI process. This guide provides step-by-step instructions to help you complete the form accurately and thoroughly.
Follow the steps to fill out the MRI Procedure Screening Form.
- Press the ‘Get Form’ button to access the MRI Procedure Screening Form. This will enable you to view and edit the document online.
- Begin by entering your personal information, including your name, date of birth (DOB), sex, age, weight, and patient number. This information helps the medical team identify you and understand your health context.
- Indicate the type of MRI procedure you will be undergoing and provide the reason for the MRI, including any related symptoms you are experiencing.
- Answer whether you have had any prior exams related to today’s study, and if so, specify the date and location of those exams.
- List all prior surgeries you have undergone, as this information may be relevant to the procedure.
- Respond to questions regarding your medical history, including any conditions such as claustrophobia, previous MRI or CT scans, eye or body injuries involving metallic objects, cancer history, and treatments like chemotherapy or radiation.
- Provide information about any chronic conditions you may have, such as diabetes, renal disease, or blood disorders, and indicate if you are currently on dialysis or have had a liver transplant.
- Confirm your pregnancy status, including the date of your last menstrual period, and whether you are currently breastfeeding.
- Acknowledge any metallic, electronic, or medical implants and devices you possess, marking yes or no as applicable for each listed item.
- Report any allergies you may have, including food, medications, or homeopathic remedies, and list any current medications or remedies you are taking.
- Review the warning statement regarding the strong magnetic field of the MRI system and confirm your understanding of the precautions.
- Finally, attest that the information provided is correct to the best of your knowledge by signing and dating the form. A representative may also need to sign the form if applicable.
- Once completed, save your changes, and choose to download, print, or share the filled form according to your needs.
Complete your MRI Procedure Screening Form online today to ensure a smooth process.
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For this reason, the image quality will be low, and the machine may not analyze the soft tissue. An open MRI is disadvantageous because the scanner remains open on 4 sides. The magnetic strength spreads across the top and bottom. So, you may not find good quality.
Fill MRI Procedure Screening Form - Novant Health - Novanthealth
MRI Patient Questionnaire. Please mark on this drawing the location of any metal inside your body. The screening process that utilizes written screening forms is basically the same for MR and non-MR personnel. Novant Health's imaging healthcare specialists offer the expert, compassionate medical imaging you deserve, including CT scan, MRI, and nuclear medicine. Novant Health Imaging SouthPark provides services including MRI scans, CT scans, ultrasounds and X-rays. Contact us for an appointment. Novant Health Imaging at Presbyterian Medical Center offers MRI, CT and PET scans, ultrasounds, X-rays, nuclear medicine and internal radiation.
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