Examination CT-scan with drinking constrast solution

Checklist for IV contrast solution to be completed three weeks before your appointment

MijnRadboud

Before the contrast solution can be administered, we kindly ask that you print out and complete this contrast checklist at home. You can do this via MijnRadboud or by using the activation code in your appointment letter.
Please complete this checklist three weeks before your appointment. This will give us enough time to make any changes that may be necessary. Once you have completed the checklist via MijnRadboud or by using the activation code, we will contact you if we need more information.
More information about MijnRadboud.

Activation code

If you received an activation code in your appointment letter, you will have to activate it before it expires. For help, watch this instructional video (YouTube). You can activate the code via MijnRadboud. This site also contains more information about the activation code.

Direct login

To log in to MijnRadboud with your username and password, click here.
To return to MijnRadboud, click on the image of the head at the top right corner of every page.

If you are unable to complete the checklist online, you can submit a paper version instead.

Before the contrast solution can be administered, we ask that you print out and complete this contrast checklist at home. If you don't have a printer, read through the questions anyway. You may have to call us before the procedure or we may recommend having someone else drive you home afterwards.
Go to the contrast checklist (checklist in Dutch).