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X-ray Image Request

Fill out the form below to request x-ray films for radiology procedures done at Lifetime Health Medical Group's health centers.

Please allow up to 2 business days to process your request. Please also note that you will need to sign a release form at the time you pick up your films, and that we may need to contact you for additional information.

Required fields are in bold.

Name:
Phone Number:
Please indicate the type of x-ray image you need.
Please indicate where you would like to pick up your x-ray images:	Amherst Health Center Folsom Health Center Greece Health Center Hamburg Health Center Mosher Health Center West Seneca Health Center
Name of facility/doctor that will receive images:
Provide any other information or comments that are relevant to your request:

X-ray Image Request

Convenient Buffalo Locations

Amherst Health Center

Hamburg Health Center

West Seneca Health Center

Mosher Health Center