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Highland Hospital / Departments - Centers / Breast Imaging Center / For Providers: Request Images

Request Images

Request Images

Fax a Completed Release Form to (585) 487-3309

On the release form, please clearly indicate the patient's name and date of birth, and where the images need to be sent. Please also provide a contact number, so we can reach you in case there are any questions. If you need further assistance please call us at (585) 487-3300.

Image Request Form