Request Your Images

Please allow two business days for your request to processed. All your images will be burned onto a CD-ROM except for mammograms which will be printed on film.

We will supply your exam at no charge to you. If you lose the images or require a second copy there will be a $5.00 charge per CD-ROM and $5.00 charge per film. Higher charges may apply for requests not made directly by the patient.

To save the extra cost, we recommend that you keep the disc/films in a dry place. If your doctor needs to keep the disc/films after your visit, please inform his/her staff to return the disc/films to you, not to Women’s Imaging Center. If disc/films are returned to Women’s Imaging Center they will be destroyed. DO NOT RETURN YOUR IMAGES TO WOMEN’S IMAGING CENTER.

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

Name *

Date of Request

Date of Birth *

Phone *

Email *

Type of Exam *

Date of Exam *

Where will you be taking your exams? *

What is 1+3? *