Use this form to record information about implants regarding whether it is safe to scan someone. Please conduct a preliminary review before submitting this form. 

Please do not include any Personal Health Information or identifying information (e.g., subject names, etc). Any documentation you have should be stored on the Georgetown Box Account assigned to your lab. You will be able to link the box folder with participant information at the end of the first page of this form. 

There are some implants that do NOT need to go through this approval process. For the most up to date list of these implants, please see this document. If you participant has one of the implants on this list, you can just alert your scan tech on the day of your scan, make sure it's noted on the MR screener.