Nevro HFX TSM3000 - Patient MRI Checklist; Before MRI: Doctors Request; Before MRI: Appointment Scheduling; Before MRI: Preparation Steps

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When your doctor requests an MRI scan:

Tell your physician who requested the MRI scan that you have an implanted spinal cord

stimulator device.

Find your patient ID card. If lost, please call your Nevro HFX Care Team to request a replacement.

When making your MRI appointment:

Provide the information below to the MRI facility when making your appointment:

• You have a Nevro HFX spinal cord stimulator

• If you have any other medical device implants

• A detailed description of your device including the product number, leads, and other

implant components (this information is found on your patient ID card)

• The contact information of the physician who implanted your device

• The Nevro HFX MRI Guidelines (available at Nevro.com/manuals)

Preparing for your MRI appointment:

Contact your Nevro HFX Care Team to conrm you can safely have the MRI scan ordered.

Before your MRI scan, your Nevro HFX Care Team will help you prepare your device by

conducting an impedance check.

• Please refer to pages 13-15 or NevroHFX.com/resources for step-by-step instructions.

Make sure your device is fully charged before your MRI scan.

For Implanted Patients

Patient MRI Checklist