We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Multi-State Forms
  • Ct And X-ray Contrast Consent Form

Get Ct And X-ray Contrast Consent Form

CT and XRay Contrast Consent FormToday you are scheduled to have an exam that may require you to have an injection of contrast material. Here at InHealth Imaging we use a nonionic IV contrast for.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the CT And X-Ray Contrast Consent Form online

Completing the CT And X-Ray Contrast Consent Form online is crucial for ensuring safe and informed medical treatment. This guide provides clear instructions on how to navigate the form and fill it out correctly, making the process straightforward for all users.

Follow the steps to complete the consent form effectively.

  1. Press the ‘Get Form’ button to access the consent form and open it for editing.
  2. Review the introduction section of the form which explains the purpose of the consent and mentions the use of nonionic IV contrast.
  3. Answer the initial questions regarding previous injections of X-Ray or CT dye, including any adverse reactions experienced.
  4. Provide details about any known medical conditions, such as heart conditions or kidney disease, and specify if you are diabetic or have sickle cell anemia.
  5. Indicate any history of asthma or allergies, and provide details if applicable.
  6. For users under the age of 2 or over the age of 65, ensure to check the relevant notifications.
  7. Females should answer the questions regarding the possibility of pregnancy and current breastfeeding status.
  8. Carefully read the acknowledgment section confirming that you understand the risks associated with the contrast material and give your consent.
  9. Enter the date and sign your name in the designated areas.
  10. Once you have completed the form, you can save changes, download, print, or share the document as needed.

Start completing your CT And X-Ray Contrast Consent Form online today!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

Informed consent in diagnostic radiology practice:...
by AD Baheti · 2017 · Cited by 4 — We review the evolution of the concept of informed...
Learn more
CACTIS Consent Forms | Radiology Research | Penn...
CACTIS consent forms use standard language for research involving the use of CT ... A...
Learn more
Medical imaging - Wikipedia
Medical imaging is the technique and process of imaging the interior of a body for...
Learn more

Related links form

IL Glenview Chamber Of Commerce Membership Benefits 2017 IL Building Permit Requirements - Jo Daviess County 2018 IL Application For Outdoor Seating Permit - Village Of Glencoe 2020 IL Building Permit Requirements - Jo Daviess County 2022

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Iodine-based and Gadolinium-based. Iodine-based contrast materials injected into a vein (intravenously) are used to enhance x-ray and CT images. Gadolinium injected into a vein (intravenously) is used to enhance MR images.

In institutions where department policy or legal advice based on state law requires informed consent for intravenous injections of contrast agents, ACR policy approves the obtaining of informed consent and injection of the contrast medium by qualified, credentialed technologists and nurses.

Although most academic medical centers currently have guidelines for informing patients regarding CT scans, its purpose, and some risks, they are not obtaining full informed consent because of the failure of disclosing both the radiation risks and diagnostic alternatives.

Patients should inform the radiologist or technologist if they have a history of allergies (especially to medications, previous iodine injections, or shellfish), diabetes, asthma, a heart condition, kidney problems, or thyroid conditions.

In institutions where department policy or legal advice based on state law requires informed consent for intravenous injections of contrast agents, ACR policy approves the obtaining of informed consent and injection of the contrast medium by qualified, credentialed technologists and nurses.

Contrast agents can be injected through a vein in your arm to help your gallbladder, urinary tract, liver or blood vessels stand out on the images. You may experience a feeling of warmth during the injection or a metallic taste in your mouth.

How long will the scan take? The time required will depend upon the type of scan. If oral contrast is required, about 45 to 60 minutes is needed for the contrast to move through your digestive tract. Actual scan times vary from a few seconds to several minutes.

1 Given the cost and radiation exposure, it is critical that CT is appropriate and performed with optimal technique. The decision to order contrast-enhanced CT is based on the clinical question being asked. Contrast agents are used to differentiate between organs and improve lesion detection and characterization.

If your doctor ordered a CT scan with contrast, do not eat anything three hours prior to your CT scan. You are encouraged to drink clear liquids. You may also take your prescribed medications prior to your exam. DIABETICS: Diabetics should eat a light breakfast or lunch three hours prior to the scan time.

Will It Hurt? CT scan is a painless exam. Patients who are receiving Intravenous Contrast Dye (also known as IVP Dye) may experience a warm sensation, metallic taste, and or the feeling of urination.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get CT And X-Ray Contrast Consent Form
Get form
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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