SwiftMR™ Pre-Installation Survey

To ensure a smooth installation of our SwiftMR solution at your site, please complete the following form with the necessary details. This information will help us coordinate the installation process efficiently.

Please enable JavaScript in your browser to complete this form.

Your Information

Please provide your name and contact information.

Your Name

Site Details

Please provide the site name and address.

Address

Point of Contact

Please provide the name and contact information for the POC at the site.

Are you the point of contact (POC) for this installation?

Installation Scheduling

Please provide your two preferred weeks for the installation. Note that the schedule can only be booked up to two weeks in advance.

Assigned Static IP Information

Please provide the following requested information. IP must be on network that can communication to scanner, PACS, and to the internet.

PACS Information

Please provide the IP, AE title, and port details for your PACS.

MRI Information

Please provide details for each MRI scanner, including vendor, model, year, serial number, and networking information (IP, AE, and port).

How many scanners will be installed during this demo?

MRI Scanner #1

Please provide details for each MRI scanner, including vendor, model, year, serial number, and networking information (IP, AE, and port).

Protocols

Please provide 5-7 protocols for the demo, such as Brain Routine or Lumbar Spine W/WO.