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Mri incident form 2026

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The document is a Safety Incident Report Form for the Purdue MRI Facility, which must be completed in the event of any incident that could potentially injure individuals involved with or observing an imaging session. It outlines the necessary information to be recorded, including details of the incident, resolution steps, and contact information for operators. The form emphasizes the importance of notifying the Manager of Operations if emergency personnel are required.

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Click ‘Get Form’ to open the MRI Incident Report in the editor.
Begin by entering the 'Date of Session' and 'Start Time' in the designated fields. This information is crucial for tracking the incident.
Indicate whether the incident involved a physical injury by selecting 'yes' or 'no'. If 'yes', make sure to fill in the 'Time of Incident'.
In the provided text box, describe the incident as thoroughly as possible. Include details such as what occurred, who was involved, and any immediate actions taken.
Next, detail the resolution of the incident. Document all individuals contacted and any damage to the facility that resulted from this event.
If emergency personnel were involved, ensure you notify the Manager of Operations immediately after completing this form.
Finally, fill in the names of both the Primary Operator and Secondary Operator before submitting your form.

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