Mri Safety Screening Questionnaire. Available for pc, ios and android. It is very important that you answer all of the following questions.
The screening forms are available in english and spanish in the left column of this page. Kindly remove as much jewellery as possible before attending. Patient screening patients entering an mri suite for a diagnostic exam are screened for the contraindications discussed above.
Please answer the below questions carefully.
Mri safety screening questionnaire (inpatients) ucla form #315639 rev. Mr_fm_0001 mri safety questionnaire 5 september 2017 version 7 page 3 of 3 consent for mri i attest that the above information is correct to the best of my knowledge. 1 | p a g e 4114 south jackson street san angelo, texas 76903 o: Mri safety screening questionnaire mri, unlike other methods of imaging the body, does not use radiation but rather uses magnetism and radio waves.