Get Uva Imaging Fontaine

The Uva Imaging Fontaine form is crucial for patients preparing for imaging procedures. This guide provides a clear, step-by-step approach to ensure all necessary information is accurately completed to facilitate your diagnostic imaging efficiently.

Follow the steps to complete the Uva Imaging Fontaine form online

1. Click the 'Get Form' button to access the Uva Imaging Fontaine form online in your preferred editor. This step will enable you to view and begin filling out the document.
2. Begin by entering your personal information in the designated fields. Provide your full name, height, weight, and age as prompted.
3. Select the date of your appointment and indicate the specific procedure that will be performed on you.
4. Answer the screening questions carefully. Choose 'Yes' or 'No' for each question regarding past MRI experiences, injuries, allergies, and other medical history.
5. If you answered 'Yes' to any question requiring further description, provide the details in the provided space.
6. Pay special attention to sections related to any implants, medical devices, or procedures. Indicate any relevant surgeries or health conditions that could affect your MRI.
7. For female patients, indicate if you are pregnant or experiencing a late menstrual period; for male patients, indicate if you have a penile prosthesis.
8. Review the warnings and instructions regarding safety before and during the MRI procedure.
9. After completing all sections, confirm that all information is accurate. Then, save your changes, and download or print the form for your records.
10. Share the completed form with your healthcare provider or the imaging center as instructed.

Complete your Uva Imaging Fontaine form online for a smooth imaging experience.