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 send images and reports to us prior to your appointment.
*denotes required field