Request for MR Project number at Karolinska Institutet
Please fill in this. Expected turnaround is three workdays. Following this you will get a mail with information on how to proceed.
Invoices will be issued twice per year. If you need information to correctly fill in this form please contact Mimmi.wernman@ki.se
Name of the project *
max 80 Characters
Your answer
Address for invoice *
(include attention to, reference code for either KI och ALF FoUU when applicable)
Your answer
Give name, email and mobile phone number to project leader (PI) *
Your answer
Give name, email and mobile phone number to medically responsible *
For handling of incidental findings, if n/a write so And MRC will assist
Your answer
What instrument will be used? *
Define need for nursing assistance
Include time per examination, information on image transfer needs, preparation work
Your answer
Injection of contrast? *
Time for each examination including preparation and clean-up *
Your answer
Need for extra resources at MRcenter
(at present no charges for this, but important for planning)
Define need for physics assistance
Your answer
Subject description
Please give a few lines in order to guide the neuroradiologist when reading the exam. E.g. state if it is a Patient group or healthy controls. Also state the primary clinical/biological question of the project.
Your answer
Please give email to where preliminary invoice should sent *
Required
Please indicate if you include fMRI? *
Jonathan will get in contact if you plan this
Please indicate if you include spectro *
Rouslan will get in contact
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