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New MRI Scanner Registration form

Are you an existing Resonance Health customer who wants to register a new MRI scanner? Please fill out the form below.

"*" indicates required fields

Step 1 of 3

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New scanner registration

Your Customer ID:*

Name*

First Last

Email*

MRI Scanner Details

Manufacturer:*

Siemens

Philips

GE

Other

If other pls specify:*

Model:*

Serial number if known:

Field strength:*

1.5T (All Products)

3T (Only available for FerriScan, HepaFat-Scan, and HepaFat-AI)

Can your Scanner achieve a min TE of 6.0ms (1.5T) or 5.0 – 6.0ms (3T) with a T2-weighted single spin echo (SE) sequence? (NOT TSE or FSE or GRE sequence)?*

Yes

No

Unsure

Is your 3T Scanner equipped with a dual transmission system or a single transmission system?*

Dual Transmission System

Single Transmission System

Unsure

Is your Scanner equipped with an ECG facility and a cardiac package with a multiple-echo T2* sequence?*

Yes

No

Is your scanner able to achieve a minimum TE≤3ms (1st TE) and a maximum TE≥15ms (8th TE) with a multi-echo gradient echo sequence?*

Yes

No

Unsure

Do you want to register another scanner?*

Yes

No

Manufacturer:*

Siemens

Philips

GE

Other

If other pls specify:*

Model:*

Serial number if known:

Field strength:*

1.5T (All Products)

3T (Only available for FerriScan, HepaFat-Scan, and HepaFat-AI)

Can your Scanner achieve a min TE of 6.0ms (1.5T) or 5.0 – 6.0ms (3T) with a T2-weighted single spin echo (SE) sequence? (NOT TSE or FSE or GRE sequence)?*

Yes

No

Unsure

Is your 3T Scanner equipped with a dual transmission system or a single transmission system?*

Dual Transmission System

Single Transmission System

Unsure

Is your Scanner equipped with an ECG facility and a cardiac package with a multiple-echo T2* sequence?*

Yes

No

Is your scanner able to achieve a minimum TE≤3ms (1st TE) and a maximum TE≥15ms (8th TE) with a multi-echo gradient echo sequence?*

Yes

No

Unsure

Do you want to register another scanner?*

Yes

No

Manufacturer:*

Siemens

Philips

GE

Other

If other pls specify:*

Model:*

Serial number if known:

Field strength:*

1.5T (All Products)

3T (Only available for FerriScan, HepaFat-Scan, and HepaFat-AI)

Can your Scanner achieve a min TE of 6.0ms (1.5T) or 5.0 – 6.0ms (3T) with a T2-weighted single spin echo (SE) sequence? (NOT TSE or FSE or GRE sequence)?*

Yes

No

Unsure

Is your 3T Scanner equipped with a dual transmission system or a single transmission system?*

Dual Transmission System

Single Transmission System

Unsure

Is your Scanner equipped with an ECG facility and a cardiac package with a multiple-echo T2* sequence?*

Yes

No

Is your scanner able to achieve a minimum TE≤3ms (1st TE) and a maximum TE≥15ms (8th TE) with a multi-echo gradient echo sequence?*

Yes

No

Unsure

Primary Technical Contact The Primary Technical Contact will be responsible for technical communications with us and if applicable, the scanning of the FerriScan Phantom Pack (or test patient) to verify the correct acquisition protocol has been set up.

Will the User be the Primary Technical Contact?*

Yes

No

If ‘no’, please enter the contact details of an appropriate Primary Technical Contact below:

Contact Title:*

Prefix

Contact Name:*

First

Email Address:*

Position Title:*

Prevent spam*

To send the form, please answer this question to help prevent spam: A panda is black and .....

ABN: 96 006 762 492

141 Burswood Road
Burswood WA 6100 Australia
info@resonancehealth.com

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