Version May 2024
| 1. Do you have epilepsy or have you ever had a convulsion or a seizure? |
| 2. Have you ever had a fainting spell or syncope? If yes, please describe on which occasion(s). |
| 3. Have you ever had a head trauma that was diagnosed as a concussion or was associated with loss of consciousness? |
| 4. Do you have any hearing problems or ringing in your ears? |
| 5. Do you have cochlear implants? |
| 6. Are you pregnant or is there any chance that you might be? |
| 7. Do you have metal in the brain, skull, or elsewhere in your body (eg, splinters, fragments, clips, etc)? If so, specify the type of metal. |
| 8. Do you have an implanted neurotransmitter (eg, DBS, epidural/subdural, VNS)? |
| 9. Do you have a cardiac pacemaker or intracardiac lines? |
| 10. Do you have a medication infusion device? |
| 11. Are you taking any medications? (please list) |
| 12. Did you ever undergo TMS in the past? If so, were there any problems? |
| 13. Did you ever undergo MRI in the past? If so, were there any problems? |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
