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Home > Media Center > Patient Newsletter > Spring 2011 - Buffalo > Online X-Ray Request > Online X-Ray Request Form

Online X-Ray Request Form

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

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.