Patient Information
At Your Fingertips
Release Form:
Image – Medical/Release
Great Basin Imaging is happy to provide copies of your images and/or reports to your physicians when requested. We will provide these on CD at no expense to you. Most local physicians have access to our images via a computer system, so unless your physician has specifically requested you bring either a CD or film to them, they will review your images via the computer system.
If you wish to have copies for your personal use, you have 3 options. The option you choose must be paid in advance. Reports are provided at no cost. Depending on the number of images and/or exams, the CD or paper option is the most economical. Our staff can help you figure out which is best for you.
- $25.00 fee per CD.
- Film images, $15.00 per sheet of film.
- Paper images, $1.00 per sheet of paper.
Reports of your imaging studies can be faxed at anytime to you or your physician upon request.
Please call us at 888-1180, option 4 to request copies of your films at least 24 hours in advance. You may download the attached form and complete it in advance. Please call in your request and bring the completed form with you when you come to pick up your images.
Someone else may pick up your images under the following circumstances:
- They are listed on your HIPAA release form. This is a form you completed when you registered for the first time with Great Basin Imaging. You may call 888-1180, option 3 to see who is on your form.
- If they are not listed on the HIPAA release, you may complete and sign the attached form. Write a note giving the person permission to pick up your films and attach a copy of your drivers license to that note.
Click here to download File Release Form
