GCNC MRI Core Facility Usage Application / Protocol Test
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This application is (please select one option only)
*
This application is (please select one option only)
MRI usage application (for MRI Committee's review)
Protocol Test - new request
Protocol Test - follow up test
Protocol Test was conducted for this project
Protocol Test was conducted for this project
Yes
No
MRI usage approval is sought / Application is submitted to GCNC MRI Core Facility
MRI usage approval is sought / Application is submitted to GCNC MRI Core Facility
Yes
No
Please indicate MRI Core Facility reference number (e.g. OUA001)
Please tick if appropriate.
Please tick if appropriate.
No reference number has been assigned (for protocol test arranged on or before 28 April 2021).
Disclaimer
The personal data collected will be used by the Department of Imaging and Interventional Radiology and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.