Reqeust Films

MRI of the Ankle

Important requirements and instructions for all film requests:

 Identification is required for all film pick-ups. In the event that someone other than the patient is sent to pick up the films, they must have a letter signed by the patient, granting them permission to sign out the films on the patient’s behalf.

Films will be available for pick-up at the location your study was performed. All film requests require 2 business days to process. If you are requesting a second copy of an exam you had, there will be a charge of $13 per sheet of film used to print your study. Please fill in the following information to allow your film request to be processed:

Request Films from American Radiology Services:
Your Name:
Your Phone # or Email Address:
Patients Name:
Your Relationship to the Patient:
Patients Date of Birth:
Exam Films Needed:
Location Exam Was Performed:
AnnapolisBel AirBethesdaCMIC (Calvert)FrederickGlen BurnieGreen SpringHoward CountyNewarkNorth PointOwings MillsQuarry LakeSolomons IslandTimonium CrossingWaldorfWestminsterWhite MarshWhite Marsh Open MRI*I Am Not Sure*
(if not sure you will be contacted, may delay process)
Reason for Signing out Films:
Dr. or Facility who will Review Films:
Person Picking up the Films:
Date You Wish to Pick Films Up:
 

(allow 2 business days)
Other Information or Instructions:

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