Medical Imaging

Provider Form to Request Medical Images

Providers: You can request medical imaging records for a patient as well as upload your images via our portal link.

Please note: This page is for providers only. If you are a patient, please visit the patient medical imaging request page.

Upload Patient Medical Imaging Records

Go to Powershare Easy Uploader

Request Patient Medical Imaging Records

You have three ways to request patient records. 

Authorization

Please read carefully.

By submitting this request I confirm that I am a health care provider for this patient and the request for radiology studies is for treatment purposes for this mutual patient.

Disclaimer is yes

Requestor's name
Patient Name

This form is for providers only.

Lifespan patients can request and share exam images

Request your medical images