Get Radiology Mri Patient Screening Form

Completing the Radiology MRI Patient Screening Form online is an important step in ensuring your safety and the effectiveness of your MRI scan. This guide provides clear and detailed instructions to help you fill out the form accurately and thoroughly.

Follow the steps to successfully complete the form

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin by filling in your personal information, including your full name, the date of your appointment, your date of birth, and your weight. This information ensures the medical team has essential details about you.
3. Carefully review the list of medical devices and conditions. For each item, indicate 'YES' or 'NO' as applicable. If you have any cardiac devices such as a pacemaker or defibrillator, ensure to notify the MRI technician.
4. For any surgeries or implants, provide the location and date of the procedure. This information is crucial for the safety checks before your MRI scan.
5. Specify any allergies, especially to IV contrast materials, and indicate if you are pregnant, trying to become pregnant, or breastfeeding. This information helps in tailoring your care.
6. Complete the questions regarding any metal fragments in your body, any recent EKG tests, tattoos, or body piercings.
7. Sign and date the form to confirm that the information provided is accurate. Indicate whether you completed the form yourself or someone else did it on your behalf.
8. Once all sections are completed, review your entries for accuracy. You can then save changes, download a copy, print, or share the form as required.

Complete your MRI Patient Screening Form online today to ensure a smooth and safe imaging experience.