Internal Reference Number: FOI_8762
Date Request Received: 09/07/2025 00:00:00
Date Request Replied To: 18/07/2025 00:00:00
This response was sent via: By Email
Request Summary: Radiology safety screening forms
Request Category: Health
| Question Number 1: We would ask for your NHS Trust to provide information on two aspects: Whether safety screening forms or checklists which are completed by patients prior to a diagnostic imaging examination are in paper form or in digital format (e.g. web-based or tablet)? This includes but may not be limited to: 鈥� Inclusive Pregnancy status (IPS) or last menstrual period (LMP) forms 鈥� Magnetic resonance imaging (MRI) safety forms 鈥� Contrast media administration (all modalities) 鈥� Bone densitometry (DXA) patient questionnaire 鈥� Any other examination-specific forms e.g. CT colonography or cardiac questionnaires. | |
| Answer To Question 1: All of our safety checklists/forms are paper format currently.聽 | |
| Question Number 2: If any of these are completed in paper form, we would ask for a copy of the current version to be sent via email. We do not require information regarding staff completed forms e.g. WHO safety forms however, we would request that forms initially completed by a patient and co-signed by a staff member at the time of the examination are included. | |
| Answer To Question 2: Please find attached current versions To accompany this answer to question 2 please also see the documents listed below:  Buscopan checklist.pdf CT checklist.pdf CT Colonography Checklist jan 2021.pdf IV Gadolinium safety questionnaire.pdf MRI Patient Safety Questionaire Nov 23.pdf MRI safety questionnaire.pdf Renal safety questionnaire.pdf 91影视 Inclusivity Pregnancy Status 10 day rule.pdf 91影视 Inclusivity Pregnancy Status 28 day rule.pdf | |
| Please see Attachments: | |
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Our staff at 91影视 District Hospital have long been well regarded for the quality of care and treatment they provide for our patients and for their innovation, commitment and professionalism. This has been recognised in a wide range of achievements and it is reflected in our award of NHS Foundation Trust status. This is afforded to hospitals that provide the highest standards of care.
