Regional Medical Imaging
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Film Pick-up Request

For questions about your film request, please contact us at (810) 732-1846. We will confirm your request by phone or by email. On-line requests will be followed up within 1 business day of request receipt (Monday through Friday, 8:00 am and 5:00 pm ). If you do not receive a response from us within 48 hours, please contact our office by phone at (810) 732-1846.

Important Items to Note

  • Allow 2-3 days advance notice of desired film pick up.
  • When picking up your films or reports, you will need to present photo identification.

An asterisk (*) indicates required information

PATIENT INFORMATION  
First Name*
Middle Initial
Last Name*
Address
City
State
Zip Code
Email
Patient's Date of Birth*
Social Security Number (optional)
Phone*
Alternate Phone*
FILM REQUEST  
What specific films are you requesting and approximate date of exam?*
Film Type
PICK UP LOCATION  
Pick Up Location*
OTHER DETAILS REQUIRED  
What doctor's office or facility are you taking these to? (Please indicate your doctor's first and last name.)*
 
 

 
Regional Medical Imaging, P.C. | 3346 Lennon Road, Flint, Michigan, 48507 | (810) 732-1919
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