How is your heart working??
Texas Heart Institute is excited about being able to provide our heart screenings onsite at Pin Oak Middle School.
The screening is free and is part of a clinical research study which uses EKG and a MRI tests. The purpose of the screening is to determine if these imaging tests can identify children who have undetected heart conditions that can lead to sudden cardiac death.
Children will not give blood or be given any medications or injections during the screening. Screening appointments are scheduled during their PE class or during one of their elective classes; appointment scheduling is coordinated with the assistance of a Pin Oak Middle School staff liaison. The minimal risks associated with the MRI screening include: allergic reaction from placements of the electrodes, being mentally and/or physically uncomfortable during the MRI, injury to the fetus in pregnant females and effects from having metal implanted in your body.
There is no risk associated with braces, permanent retainers or dental implants.
The documents related to participating in the screening study are attached for your review. The "Informed Consent Completion and Feedback Form" provides instructions for completion of these documents. Our office must receive the completed documents listed below before your child's screening appointment will be scheduled. Please don't forget your signature and the date.
• Informed Consent Completion and Feedback Form
• Consent Form
• Baseline Data Form
• MRI Safety Form
Click HERE to obtain a copy of these forms in English.
Click HERE to obtain a copy of these forms in Spanish.
The "Pediatric Subject Assent Form" should be reviewed at home but does not need to be returned. The assent form will be completed when their screening is scheduled.
Please return the completed forms listed above, with your signature and the date, to the school administration office or to their PE coach. Since these documents will contain "confidential information" when completed, we ask that you return completed forms in a sealed envelope to assure protection of that information marked to the attention of the "Texas Heart Institute". If you decide not to allow your child to participate, please return the completed "Informed Consent Completion and Feedback Form".
Please call our office at (713) 218-2112 or email us at firstname.lastname@example.org if you have additional questions or concerns related to the study. Thank you for your interest in the