Radiology Imaging Library (Moffit-Long Hospital)
505 Parnassus Ave., Room M381
San Francisco, CA 94122
Tel: 415-353-1640
Fax: 415-353-8583

Radiology Imaging Library (Mount Zion Hospital)
1600 Divisadero , Room A118B
San Francisco, CA 94118
Tel: 415-885 7466
Fax: 415-885-7449

To request your images and report:
A CD with images/report will be provided as requested at no charge. Please fill the Release of Information form (pdf), sign it, and fax it to 415-353-8583 or 415-885-7449 (Mt. Zion site).

Please include the following information:

• Patient Name
• Birthdate
• Medical Record Number (if you know it)
• Your contact telephone number
• Date and type of exam requested
• Complete address including zip code

Radiology Consultation Service:
Radiology Consultation Service provides official reading for exams performed at another facility. A requisition signed by the provider must be submitted with CD or Films. The following information must be included.

• Patient's name
• Medical Record Number
• Date of exam requested for second reading
• Type of exam requested for second reading
• Diagnosis Provider signature
• Contact telephone number
• Type of Insurance with appropriate authorization number if required. If no authorization is needed, please indicate "No Authorization needed"

If you need assistance with this process, please call 415-353-1640 or 415-885-7760.