Request a Copy of Your Imaging Study

Radiology Imaging Library

1. Fill out the Authorization for Release of Health Information form (PDF). Do not use the fax or address on the form, please use the fax or address below.

Please include the following information:

2. Fax or mail the completed form to:

FAX: (310) 825-3205
Mailing Address:
Image Management, Release of Information
200 Medical Plaza
B1- Level, Suite 165-11
Los Angeles, CA 90095-78305

3. To validate the request and coordinate pickup, call the Imaging Library at (310) 825-6425

4. Call us to arrange payment if appropriate.

The Image Library reserves the right to comply within five business days of receipt of a signed authorization.

You may also pick up your images at the following locations. Arrangements should be made in advance.

For Patients