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7735 National Turnpike, Suite 100
Louisville, Ky 40214

278 C. America Place
Jeffersonville, IN 47130

File Management Pros, LLC

Remember... X-Ray Management & Medical Records Solutions are our business... our only Business."

Digital Scan Request Form

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Date: * 
Hospital Name: * 
Requested By: * 

 

Medical
Record #		 Last Name First Name Date of Birth Exam Type Exam Date Accession # X-ray Record # Box # *

* Box number is for office use only

 

Verification Code:

 

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