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  • Magnetic Resonance Imaging Mri Consent Form

Get Magnetic Resonance Imaging Mri Consent Form

Thomas E. Fithian, M.D., F.A.A.O.S. Jon H. Swenson M.D., F.A.A.O.S. Anthony T. Carter M.D., F.A.A.O.S. Daniel R. Cavazos M.D., F.A.A.O.S. John W. Aldridge M.D., F.A.A.O.S. Adrian T. Baddar M.D., F.A.A.O.S.

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In a planned procedure, the patient should receive information, verbally or in writing, in sufficient time before the procedure to consider it and to consult others if they so wish. The patient should have their informed consent confirmed at a separate discussion with the radiologist performing the procedure.

The MRI questionnaire is designed to identify all potential implants and/or foreign bodies that the patient has. These are then assessed to decide whether there is a risk involved in scanning the patient. In cases where implants are common or well-known, radiographers will decide whether imaging can proceed.

By my signature below, I hereby certify that I have fully read this consent, had it explained to me or have had it read to me. I have been given an opportunity to ask questions about my condition, alternative forms of treatment, and the procedures to be used, and the risks and hazards involved.

The FDA takes a risk-based approach to medical device regulation, and MRI scanners are Class II (moderate risk) medical devices, meaning that an MRI manufacturer is required to submit a 510(k) notification prior to marketing their MRI System.

I have received a thorough explanation about the purpose and risks of MRI scans by reading “Information about Magnetic Resonance Imaging (MRI) Scan”, and I understand the content. As a result, I agree to have an MRI scan. (Even after you sign, you can withdraw your agreement at any time.)

Magnetic resonance imaging (MRI) of human subjects is widely performed for clinical and research purposes. Clinical MRI requires a physician order, while research MRI typically requires an approved protocol from a local Institutional Review Board, as well as informed consent.

Magnetic resonance imaging (MRI) of human subjects is widely performed for clinical and research purposes. Clinical MRI requires a physician order, while research MRI typically requires an approved protocol from a local Institutional Review Board, as well as informed consent.

“What information will the MRI scan provide? How might this change my treatment options?” “Is there any reason why I shouldn't have an MRI scan?” (If you have any implanted devices (such as a pacemaker, stents, an pump, or an artificial joint), be sure your doctor knows about them.)

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232