Patients must complete this form to request medical records to be added to their FollowMyHealth portal.
Don’t have a FollowMyHealth login? Click here to register!

    Radiology Images ONLY
    If you are only needing a copy of Radiology Images, please fill in your contact information, check the box next to Radiology Images and electronically sign and submit your request. OCI Imaging will email when available to be picked up.

    Radiology Images on CD - $10 fee

    By submitting this request you acknowledge that payment is required prior to release of records. An invoice will be sent to the email or fax number provided above. Delivery times are from the date payment is received.

    Your Signature