Patient Consent for Release of Breast Images and Reports

If your last mammogram was performed somewhere other than Houston Methodist, we would like to get your images and reports.

  • This allows our Radiologists to compare your previous images to your new images.
  • By completing this form, you give Houston Methodist Sugar Land Hospital authorization to receive your images and results.

We will request your previous facility to:

  • Upload all images and reports to an unencrypted DICOM compatible CD.
  • Mail to:
    Houston Methodist Breast Care Center at Sugar Land
    16655 Southwest Fwy.
    Sugar Land, TX 77479
  • Or allow a Houston Methodist Sugar Land courier or yourself to pick up your images and reports

*denotes required field

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