TMS Checklist
TMS Checklist
TMS Checklist
11. Do you have a medical condition (diabetes, asthma, or heart disease)? YES/NO
12. Do you take any medication (except from contraception)? YES/NO
If YES, specify:
13. Do you have any implanted device (electronic, mechanical or magnetic) YES/NO
such as: pacemaker, medical pump, surgical clip, cochlear implant, or
anything else?
14. Have you ever been injured by metal fragments or worked with YES/NO
machines without eye protection?
15. If you are a woman, is there any chance you are pregnant? YES/NO
16. Is there anything else we should know? YES/NO
If YES, specify:
17. Do you need more information about TMS and associated risks? YES/NO
Thousands of healthy subjects and patients have already undergone TMS allowing the relative
risks to be assessed. The occurrence of seizures (i.e., the most serious acute TMS-related side
effect) has been extremely rare, and in those few cases, subjects answered ‘YES’ to one or
more questions.
I have read and understood all the questions and declare that to the best of my knowledge the
above information is correct.