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How to Request Your Images from Radiology

Please print the "Authorization for Release of Information Form" and complete the following sections on the form:

  • Name
  • Date of Birth
  • Date(s) of Treatment
  • Release or Mail To (patient, physician or institution information)
  • For the purpose of (follow-up, second opinion, treatment, etc.)
  • Signature, Date and Time

(Fill out the above info on page 1 of the form only. However, please return both page 1 and 2 to the Radiology Department).

Option 1:  Picking Up in Person

You will need to bring the following to:

Barnes-Jewish Hospital (North Campus)
Center for Advanced Medicine (CAM), 2nd floor  – Film Library
4921 Parkview
St. Louis, MO 63108

  • Completed “Authorization for Release of Information Form”
    • Picking up in person usually takes 10 to 15 minutes.  To help speed this process up you may choose to fax this form in advance to 314-454-5262 or call ahead to 314-454-8930.
  • Photo ID
  • If someone other than yourself will be picking up the CD, you must include a handwritten or typed note stating the following:
    • Statement – I hereby authorize (name of person picking up the CD) to pick-up my health information from Barnes-Jewish Hospital Radiology
    • Exam Information – Date and type of Radiology exam
    • Date – Date the letter was prepared
    • Signature – Signature of the patient

Option 2:  Mailed to Your Home

Barnes-Jewish Hospital
One Barnes-Jewish Hospital Plaza
Department of Radiology
Attention:  North Campus Film Library
Mailstop # 90-33-682
St. Louis, MO 63110

  • If you are having the CDs mailed to you please make sure to print the correct home address in the “Release or Mail to” section of the authorization form.

Radiology, North Campus

Step by step walking tour to Radiology at Barnes-Jewish Hospital North Campus, Center for Advanced Medicine.

 

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