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Technical Prospects is now DirectMed Imaging. Double the expertise, one comprehensive brand. Learn more.X

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(855) 463-3727
sales@directmedimaging.com
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12525 Stowe Drive
Poway, CA 92064
1000 S County Road CB
Appleton, WI 54914

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DirectMed Imaging Subsidiaries include LBN Medical, ScanMed & Titanium Medical Imaging. Technical Prospects is now DirectMed Imaging. | Privacy Policy – Terms of Sale

Get a Fast Part Quote.

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What can we help you with today?

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Additional Comments

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MRI Coil Repair Form

Contact Name:*
Organization:*

Company/Hospital/Imaging Center
Contact Phone*
Contact Email:*
Facility Name*
Coil Information
Model Number:*
Serial Number:*
Coil Description:*
MRI Frequency:*

MHz
Field Strength:*

T
Problem Description
Brief description of problem:*
Is the problem:
- Intermittent
- Always Present
- Happened once or Don't know
Additional information
- Will not scan
- High Noise or Grainy Images
- Artifact
- Homogeneity (Non-uniform or shaded images)
- Mechanical Problem(Please specify below)
For Artifacts:
- Localized
- Global Bright Area
- Dark Hole
- Shading
- Ripple Patterns
If Homogeneity:
- Poor uniformity
- Fat Saturation problem
If Coil Won't Scan
- TR Driver Fault
- Coil not identified
- No Signal or Frequency not found
Are any system error messages shown?
Other symptoms or problems:
Which section, modes, or channels?

Please specify which sections, channels, modes have the problem? (i.e., C-section on CTL coil)
Shipping & Payment Information
Shipping Account Number (Optional)

If left blank, we will use our account.
Please ship via:*
- FedEx
- UPS
- Other
Shipping*
- Next Day 8 AM
- Next Day 10 AM
- Next Day PM
- 2nd Day
- Express Saver
- Ground
Repair Fees to be paid by:*
- Credit Card (Please call with credit card information. Numbers not kept on file)
- Net 30 terms (For credit approved customers only)
- Wire Transfer
- Check To Be Mailed
Shipping Insurance Value $*
PO#*
Accounts Payable:
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Sell Your Used Scanner

Name
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Which of These Best Describes You?*
Manufacture*
Date of Manufacture**
Model / Series**
Describe Your Imaging Project and Reason for Sale*
Project Timing*
Asking Price*
Functional?*
- Yes
- No
- Installed
- De-Installed
Site ID*
System Serial Number and Magnet Serial Number*
Magnet Type*
Coils (Please specify any multi-channel coils and number of channels)*
Slew Rate*
Software Revision Level(Options enabled on system, rev level, other features, and hardware)*
Current Service Provider*
- Independent Service
- In-house Service
- OEM Service
- Other
- None
System Location: Facility Type*
Loading Dock at Facility*
- Yes
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Diagnostic Imaging Equipment Quote Request

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