Pick Up Your X-Ray Films

To pick up your x-rays from our storage facility in Novato, please fill in the fields below. Your x-ray films will be pulled and will be ready to be picked up within 2-4 business days from the date that you submit this form.

When you click enter below, you will be asked to pay a one-time $9 fee through any credit card. Once you pay this fee, we will e-mail you with the address and phone number of our storage facility.

Once you pay this fee, we will e-mail you with the address and phone number of our storage facility.

First Name:

Last Name:

Date of Birth:

Phone Number:

E-mail Address:

I agree that I am the patient who is requesting these films.

NOTE: If you are a representative of the patient (such as a law firm or other office), you will need the patient to come to this web site directly to fill out this information. At this time, we are unable to process requests from parties other than the patient.

I agree that once I pick up these x-ray films, I will not return them to Susan Gootnick Radiology or to their storage facility.