Consent to release medical information

Why we need your consent:

You’ve been asked to complete a Consent to Release Medication Information form as you have a medical implant or device that must be assessed for MRI compatibility.

MRI scans involve strong magnetic fields that can potentially interact with certain implants or medical devices. While some devices are MRI-Safe, others may pose risks if not compatible, such as:

• heating of the device which can causes burns
• movement or displacement, which may lead to tissue damage
• malfunction or permanent damage to the device itself

To ensure your safety, we need to carefully review your hospital medical records to identify the specific make and model of your implant or device.

Please Note: your doctor's rooms typically do not hold detailed surgical inventory records. These can only be obtained from the hospital where your procedure was performed.

The surgical notes allow us to check manufacturer guidelines and MRI compatibility before confirming your MRI appointment.

Before we can request or access your medical records, we are legally and ethically required to obtain your consent. This ensures your privacy is protected and you remain in control of your personal health information.

Thank you for your understanding and cooperation in helping us provide safe and effective care.