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Why 3D?
About Us
Patient Information
Schedule An Appointment
Insurance & Grants
Contact Us
Request Your Images/Reports
Images/Reports Request Form
Full Name
Birthday
Email Address
Phone
Home Address
If you need a copy of your patient letter let us know how you'd like to receive it
Delivery via Mail
Secure Email
If you need a copy of your report sent to your physician please enter their name and fax number
If additional imaging or follow up has been advised by your physician, please let us know where you want your images sent:
Home Address
Facility
If you answered facility please enter the name and address of the facility you want them sent
Do you need the password for your emailed letter resent?
*
Required
Yes
No
Submit
Thanks for submitting!
If you received your letter electronically the password
is your first name and year of birth ex Mary1968.
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