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MRI Scheduling Questionnaire

Does the patient have a Cardiac Pacemaker?

~ If yes, they can not have the exam done.

Does the patient have any Aneurysm Clips?

~ If yes, they can not have the exam done.

Does the patient have any type of foreign body, shrapnel or bullet in them?

~ If yes, then your radiologist must be contacted for approval before the exam can be done.

Does the patient work around metal; examples would be a welder, or some type of a machine shop worker?

~ If yes, then the patient needs to have X-rays, or a CT exam of the orbits before the exam can be done. This should be done before scheduling an MRI exam. If metal exists in the orbits, an MRI cannot be done.

Is the patient pregnant or suspect that they are pregnant?

~ If yes, the referring physician needs to consult with the radiologist. The referring physician must explain the potential risks to the patient prior to the exam.

Is the patient over 350 lbs?

~ If yes, this exceeds the weight limit on the gantry.

Has the patient been asked about being in small-enclosed spaces (claustrophobia)?

~ If the patient is not sure or shows signs of apprehension their physician may want to consider oral sedation.

Has the patient been given oral sedation?

~ If oral sedation is prescribed the patient will need someone to drive them to the exam and them back home after the exam.