Get Kaiser Permanente Mri Screening Questionnaire 2003-2025
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How to fill out the Kaiser Permanente MRI Screening Questionnaire online
Filling out the Kaiser Permanente MRI Screening Questionnaire is an important step in ensuring your safety and preparedness for the MRI procedure. This guide provides step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to complete the questionnaire successfully.
- Press the 'Get Form' button to access the MRI Screening Questionnaire in the online editor.
- Begin by entering your personal information at the top of the form, including your name, Medical Record Number (MRN), and the date of the questionnaire.
- Answer whether you have had a previous exam related to this problem by selecting ‘Yes’ or ‘No.’ If yes, fill in the 'When' and 'Where' fields.
- State if you have taken any medications today to reduce anxiety for the MRI exam, answering ‘Yes’ or ‘No.’
- Confirm if you have ever had surgeries or procedures involving your brain by selecting ‘Yes’ or ‘No,’ and provide necessary details.
- Complete the MRI Hazard Checklist by indicating whether you have any specific medical devices or conditions by selecting ‘Yes’ or ‘No.’
- Review the HARD STOP instruction. If any previous responses indicate a 'Yes,' you must hold the MRI and have the ordering physician consult with the Radiologist.
- Finally, verify the information, sign and date the form at the bottom, and ensure all required fields are completed.
Complete the Kaiser Permanente MRI Screening Questionnaire online to ensure a safe and efficient experience.
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Because of this magnetic field and the associated radiofrequency energy, providing MRI screening for patients and staff is critical to their individual safety. Screening ensures that no ferromagnetic objects or objects (in or on anyone) that conduct electricity enter the magnetic resonance (MR) scanning area.
Fill Kaiser Permanente MRI Screening Questionnaire
Do you have any metal in your body? â–¡ Yes â–¡ No. If yes, where: â–¡. Kaiser Permanente Clinical Review Criteria are developed to assist in administering plan benefits. Discusses test (also called MRI scan) that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. Medical Technology Assessment Criteria. Have you ever had an MRI before? Yes No. Have you had any imaging related to your presentation? This questionnaire is designed to assist us in determining if it is safe for you to undergo a magnetic resonance imaging procedure. "KP" means an entity participating in the integrated health care delivery system doing business as Kaiser. Documents pre-screening methods on MRI questionnaire.
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