Patient Form to Request Medical Images
Lifespan providers have automatic access to your radiology images through MyChart!
If your provider is outside of the Lifespan system, images can be sent directly to your provider for coordination of care upon request.
Digital Uploads and Requests
Requests for Physical Media
We cannot release medical images without written consent from the patient.
You also have the option of filling out the authorization form and faxing it to 401-444-4133 or emailing it to email@example.com.
Download the form at this link: Authorization for Use of Protected Health Care Information Form (PDF download)
We offer convenient pick-up locations in Providence a short distance from The Miriam and Rhode Island hospital campuses.
For Newport Hospital CD pickup please call 401-845-1338, Option #2.