This form is an evaluation form that requests general information as well as some medical and health history of the patient who intends to undergo an MRI scanning. An MRI is a medical imaging technique that uses a magnetic field and radio waves to create images of the body's organs.The process of MRI scanning has certain precautions and thus a screening about the person must be needed to be gathered. Thus, the questions that might affect an individual are being sought for in the screening form such as whether an individual has implants or objects inserted in his/her body that can be hazardous or may lead to problems with the result of the image.