How to use or fill out consent for MRI imaging & contrast administration during
- Click ‘Get Form’ to open it in the editor.
- Begin by entering the Patient Name and Date of Birth in the designated fields. This information is crucial for identifying the patient.
- In the 'Procedure to be Performed' section, clearly specify the MRI examination that will be conducted. Ensure this aligns with your medical provider's instructions.
- Review the 'Technique of Procedure' section carefully. Familiarize yourself with how MRI works and its implications, especially regarding pregnancy.
- Read through the 'Risk(s) of Procedure' section thoroughly. Acknowledge any potential risks associated with MRI during pregnancy as outlined.
- In the 'Use of Contrast Media During Pregnancy' section, understand that safety has not been established. Confirm with your physician if contrast media is necessary.
- Sign and date where indicated for both Patient and Guardian signatures, confirming your understanding and agreement to proceed with the procedure.
- Finally, ensure that the Radiologist/Physician Declaration is completed by your physician, affirming all questions have been answered satisfactorily.
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