Requesting Studies on CD

Submit an Authorization to Release Protected Health Information form or a signed letter to the Radiology Imaging Release Unit. Details below.

Please include the following if you are submitting a letter:

  • Name, date of birth, and Duke medical record number if available.
  • Name and address of the individual or institution where to send your copy or person picking up CD.
  • Radiology exam and exam date to be copied.
  • Signature of the patient or legal guardian, and date.
  • If you are submitting a request on behalf of an adult for whom you are the executor or the power of attorney, a copy of your legal documentation must be provided.
  • If you are picking up a CD, please remember to bring your picture ID, it will be required.

FORMS

(Please click to print)

Mailing Address:

Duke University Hospital
Radiology Imaging Release Unit
Box 3808, Green Zone Room 08CM
Durham, NC 27710

Physical Address:

Duke University Hospital
Radiology Imaging Release Unit
2301 Erwin Road, Room 1512B1
Durham, NC 27710

Phone: (919) 684-7860
Fax: (919) 684-7139