Get Mri Questionnaire

The screening form for individuals requests general information (name, age, address, etc.) and poses important questions to determine if there are possible problems or issues that should be discussed with the individual prior to permitting entry to the MR environment.

The screening form for individuals requests general information (name, age, address, etc.) and poses important questions to determine if there are possible problems or issues that should be discussed with the individual prior to permitting entry to the MR environment.

Patient Screening It will be the responsibility of the MRI technologist to review the MRI screening form prior to allowing a patient into Zone 3/4. All contraindications are to be brought to the attention of the MRI radiologist in-charge of the case.

Before entering the MR system room, you will be asked a variety of questions (i.e., using a special screening form) including if you have implants or devices. Next, you will be instructed to remove all metallic objects from pockets and hair, as well as metallic jewelry.

Always, place a cloth material between the wires and skin to help prevent burns.. Who must be screened before entering the scan room? EVERYONE!!! Every person that enters the MRI room must be screened for possible contraindications that could affect their health and safety.

You can find the MRI Pre-Screening Checklist in Epic by going to Order History and finding the order for the MRI....There are four zones in the MRI department: Zone 1: General public. Zone 2: Pre-screened patients/visitors. Zone 3: MRI control room/restricted access. Zone 4: MRI scan room/restricted access.

The MRI questionnaire is designed to identify all potential implants and/or foreign bodies that the patient has. These are then assessed to decide whether there is a risk involved in scanning the patient. In cases where implants are common or well-known, radiographers will decide whether imaging can proceed.

To go back and review the completed checklist, go to the Imaging tab in Chart Review. Select the MRI order, the details of the MRI will show in the preview portion of the screen (including the details of the completed screening form). At the bottom of the report, you will see the form history of who completed the form.