Get Ucsb Brain Imaging Center Magnet Screening Form - Bic Ucsb

Filling out the UCSB BRAIN IMAGING CENTER MAGNET SCREENING FORM is a crucial step in ensuring your safety during an MRI procedure. This guide provides clear and detailed instructions to help you complete the form accurately and efficiently online.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to access and open the form in your browser.
2. Begin by entering the date at the top of the form in the specified format: month/day/year.
3. Provide your subject ID, full name (last and first), date of birth, and age. Make sure to include your height and weight in the respective fields.
4. Select your middle initial, indicate your gender by checking the appropriate box, and fill in your address details including city, state, and zip code.
5. Enter your home telephone number in the specified format. Additionally, provide your email address for communication.
6. Answer the demographic questions by checking the appropriate box regarding your ethnicity/race.
7. Respond to the screening questions listed, providing details about any surgeries or MRI experiences. Indicate 'Yes' or 'No' as applicable and provide additional descriptions where prompted.
8. For female volunteers, answer the question regarding pregnancy status as 'Yes' or 'No'.
9. Indicate if you have any implants or devices by checking the corresponding boxes and specifying any additional information as needed.
10. Review your answers for accuracy. After confirming that all information is correct, proceed to complete the attestation section by providing your signature and printed name, as well as the date.
11. Ensure that the form is fully completed and all required sections are filled out, then save your changes. You can also download, print, or share the form as needed.

Take the next step in your MRI preparation by completing the UCSB BRAIN IMAGING CENTER MAGNET SCREENING FORM online now.