DIIR MRI Usage Application / Protocol Test
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This application is (please select one option only)
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This application is (please select one option only)
Philips MRI usage application
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 DIIR
MRI usage approval is sought / Application is submitted to DIIR
Yes
No
Please indicate MRI Core Facility reference number (e.g. MRI2023_1)
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.