To be prompted to save study changes before closing a patient's studies, use the User Profile tab of the Customize dialog.
To be prompted for study save on close
If setting preferences for other users, impersonate the user or role.
Press F12 or, from the Image area top toolbar, click Customize.
In the Customize dialog, switch to the User Profile tab.
Under Startup Defaults, select the Prompt to save study checkbox.
Switch to the Configurable Study Save tab, and select the checkboxes of the types of changes to save.
To save the setting and close the dialog, click OK.
The change takes effect the next time images are loaded into the Image area.