For which patients should a Clinic Screening Form be created?

In general, a CSF should be created for ALL patients who go into the screening log. In some cases, it may be possible to determine definitively from a review of the patient’s medical record that they do not meet eligibility criteria. “Black and white” examples of this would be a patient who has already had a rotator cuff surgery on the affected side, a patient who has a pacemaker (contraindication for MRI) or a patient who has a legal guardian/conservator and is not able to provide informed consent. However, if there is any doubt or “gray area” as to whether something in the patient’s history would exclude them or not, a CSF should be filled out so that the physician can make the determination.