Follow the steps to complete your MRI questionnaire online.

1. Click ‘Get Form’ button to access the MRI Questionnaire Form and open it in your editor.
2. Begin by filling in your personal information. Input your full name, occupation, age, date, and the name of your referring doctor.
3. Provide details regarding your symptoms in section A. Clearly outline the symptoms that prompted your doctor to order the MRI.
4. In section B, indicate whether you have had x-rays or other examinations of the relevant body parts by selecting ‘Yes’ or ‘No’. If you answered ‘Yes’, provide the details.
5. For section C, indicate if you have ever had any operations. Select ‘Yes’ or ‘No’ and list the types of surgeries along with the locations and dates, if applicable.
6. In section D, answer whether you have any allergies by selecting ‘Yes’ or ‘No’. If ‘Yes’, list the allergies you have.
7. Section E pertains to anemia or blood cell abnormalities. Indicate your status by selecting ‘Yes’ or ‘No’ and provide details if applicable.
8. Continue with the series of yes/no questions about medical history, ensuring to answer truthfully. If you select ‘Yes’ for any questions, it is essential to inform the staff.
9. Lastly, to provide feedback on how you learned about Rye Radiology MRI, fill in your response in the corresponding field.
10. Remember to sign the form at the bottom before finishing. Once completed, you can save your changes and choose to download, print, or share the form as needed.

Take a moment to complete your MRI questionnaire online and ensure a seamless appointment.