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Image Request

For Patients: All CD requests require 72-hour notice. The first copy for every exam is free.  The following fee schedule applies to duplicate copies: $25 per CD. The mailing fee is $2 for CDs. Reports cannot be mailed. In accordance with Florida Statute 766.1065, no one can pick up records on your behalf unless a signed Authorization to Release PHI form is in your chart. Please stop by the office to sign a form in person.

For Physicians: If you are not the original referring physician, a signed medical records release must be on file before the images and/or report can be released to your office.

To request images, please provide the information below.

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