Records Request

Instructions for obtaining records

Download the records request form by clicking on the link below and email it along with the patient consent form, payment, and other information to info@firstlookmri.com or fax to 470-777-2617. Once received, we will process the request, usually within 48 hours.


***We only accept credit card payments. No checks are accepted. Include the credit card information on the records request form or call to provide the credit card number.


CHARGES

MRI Report ($10 per exam)

Billing information ($10 per exam)

CD of images ($10 per exam)

Mail CD or medical records ($10 total)

Notary Fee ($5 total)



Click to download:

RECORDS REQUEST FORM.