F. G. Shellock

The screening forms, Magnetic Resonance MR ; Procedure Screening Form For Patients and Magnetic Resonance MR ; Environment Screening Form for Individuals were developed in conjunction with the Medical, Scientific, and Technology Advisory Board and the Corporate Advisory Board of the Institute for Magnetic Resonance Safety, Education, and Research IMRSER ; , 2002 F. G. Shellock, 2002]. [see chp drug formulary for specific details regarding coverage and authorization requirements] physician pcp orders par ; referral non-par ; yes, following a mastectomy and combivent.Tell me about your housing situation.Are your living arrangements suitable for you at this time?

By Frank G. Shellock, Ph.D.

...
A screening form for patients developed by Sawyer-Glover and Shellock (2000) was recently revised in consideration of new information in the peer-reviewed literature.This two-page form entitled "Magnetic Resonance (MR) Procedure Screening Form for Patients" was also created in conjunction with the Medical, Scientific, and Technology Advisory Board and the Corporate Advisory Board of the Institute for Magnetic Resonance Safety, Education, and Research (IMRSER).A downloadable version of this form may be obtained from the MR safety Web sites (www.IMRSER.org and www.MRIsafety.com).

Page one of this screening form requests general patient-related information (name, age, sex, height, weight, etc.) as well as information regarding the reason for the MR procedure and/or symptoms that may be present.Pertinent information about the patient is required not only to ensure that the medical records are up to date, but also in the event that the MR facility needs to contact the referring physician for additional information regarding the examination or to verify the patient's medical condition.

...
The screening forms "Magnetic Resonance (MR) Procedure Screening Form For Patients" and "Magnetic Resonance (MR) Environment Screening Form for Individuals" were developed in conjunction with the Medical, Scientific, and Technology Advisory Board and the Corporate Advisory Board of the Institute for Magnetic Resonance Safety, Education, and Research (IMRSER), 2002 (c) F. G. Shellock, 2002]

Bibliography

http://www.mrisafety.com/

http://www.imrser.org/

By Frank G. Shellock, Ph.D.
...
A screening form for patients developed by Sawyer-Glover and Shellock (2000) was recently revised in consideration of new information in the peer-reviewed literature.This two-page form entitled "Magnetic Resonance (MR) Procedure Screening Form for Patients" was also created in conjunction with the Medical, Scientific, and Technology Advisory Board and the Corporate Advisory Board of the Institute for Magnetic Resonance Safety, Education, and Research (IMRSER).A downloadable version of this form may be obtained from the MR safety Web sites (www.IMRSER.org and www.MRIsafety.com).

Page one of this screening form requests general patient-related information (name, age, sex, height, weight, etc.) as well as information regarding the reason for the MR procedure and/or symptoms that may be present.Pertinent information about the patient is required not only to ensure that the medical records are up to date, but also in the event that the MR facility needs to contact the referring physician for additional information regarding the examination or to verify the patient's medical condition.

...
The screening forms "Magnetic Resonance (MR) Procedure Screening Form For Patients" and "Magnetic Resonance (MR) Environment Screening Form for Individuals" were developed in conjunction with the Medical, Scientific, and Technology Advisory Board and the Corporate Advisory Board of the Institute for Magnetic Resonance Safety, Education, and Research (IMRSER), 2002 (c) F. G. Shellock, 2002]

Bibliography

http://www.mrisafety.com/

http://www.imrser.org/