MRI Jersey
Before your scan

MRI Safety Form

An MRI uses a strong magnet, so we need to check a few things before your scan. Please answer every question honestly — it takes about a minute and keeps you safe.

1.Have you had any procedures on your heart involving the fitting of a pacemaker, stents or pacing wires?
2.Any operations on your head?
3.Any magnetic, electronic or mechanical implants?
4.Any operations in the last 6 weeks?
5.Any metal plates, pins or joint replacements?
6.Epilepsy or diabetes?
7.Any drug patches, HRT, nicotine or blood sugar monitor?
8.Have you had an MRI scan before?
Download PDF version to print & bring in →