Medical Records Release

 
 
 
 

Please allow us 24 hours to process your request from the time of submission.

Should you need a copy of your medical records, RAI provides this service free of charge. Please call (609) 585-8800 or submit the form below. I.D. is required at time of pick-up.

We will arrange to have your outside films picked up at the following towns: Ewing, Hamilton, Hopewell, Lawrenceville, Mercerville, Trenton, Pennington, and Princeton. All images will be delivered to our imaging center in time for your appointment. Please fill out, print, and sign this form and fax it to (609) 585-1825. This form must be returned before pick up can be arranged.

Patient Information
Contact Information
Study Information
Facility Information
Statement of Release
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