Kern Radiology: Film Pickup Request

For questions about your film request, please contact us at (661) 852-2241. Online requests will be followed up within 24 hours, Monday through Friday, 8:00 am to 5: pm. We will confirm your request by phone or by email. If you do not receive a response from us, please contact our office by phone at (661) 852-2241. If you are picking up your films, you will need to present identification and a signature at time of pickup.

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I am a:	Patient	Healthcare Provider

We require 24 hour notice to have films ready.
	Send films to healthcare provider listed below
	Films will be picked up at location indicated below

Personal Information
Patient's Name:	*
Patient's Phone No.:	*
Patient's DOB:	*


Films Requested What specific film are you requesting?
Exam Type:
Date of Exam:
Specific Body Part


Films to be used at appointment with:
Doctor / Facility:	*
Address / Suite:	*
City, State	*
Zip Code	*
Phone:	*
Email Address:
Date of Patient's Appointment:
Please Note: Films may not be available for immediate pickup at desired office. These films are being loaned to you and must be returned, preferably within 2-4 weeks.