Prior Imaging Records

Request missing prior women's imaging records from MSU for McLaren Lansing patients.

Preferred Contact Method

What is the best way to contact you? If N/A selected, communications will only be available via TDX application.

Preferred Contact Method Microsoft Teams Phone or Email Phone Only Email Only Onsite Visit N/A

Call Back Number

Phone number to use to contact requestor with additional questions or follow ups

Email Address

Location of Service

Location of Service Eyde MSB2/Izzo Bldg. Spartan Stadium UHW/SHS Other

Other Location

Patient Name

The name of the associated patient

Patient MRN

The medical reference number (MRN) of the patient

Date(s) of Missing Exam(s)

Date(s) of the missing exams that imaging records needs to be recovered for

Attachment

File attachments associated with the ticket.

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Other Fields

Your name

Your first name

Your last name

Your email address

Verification Code