Medical Imaging Reader Study Form
Please complete this Medical Imaging Reader Study Form to record your assessment and interpretation of the assigned imaging case.
Full Name
*
First Name
Last Name
Professional Role
*
Please Select
Radiologist
Resident
Fellow
Technologist
Other
Email Address
*
example@example.com
Imaging Modality
*
Please Select
CT
MRI
X-ray
Ultrasound
PET
Other
Case ID or Assignment Number
*
Task Type
*
Please Select
Detection
Classification
Segmentation
Measurement
Other
Primary Findings
*
Interpretation / Diagnosis
*
Confidence Level
*
Low
1
2
3
4
High
5
1 is Low, 5 is High
Additional Comments
Submit
Should be Empty: