If you've ever had an X-ray, MRI, CT scan, or ultrasound, those images belong to you. Under HIPAA — the federal health privacy law — you have the right to request and receive a copy of your medical records, including your imaging files, from any provider. Most patients don't know this, and many healthcare facilities don't advertise it.

DICOM (Digital Imaging and Communications in Medicine) is the standard file format used for medical imaging worldwide. These are the actual image files a radiologist views when reading your study — not just a printed film or a PDF report. If you want a radiology second opinion, these are the files you need.

Why You Need the DICOM Files, Not Just the Report

Your radiology report is a written summary of what the radiologist saw. But a second opinion radiologist needs to see the actual images — not just someone else's description of them. DICOM files contain the full imaging data, including multiple slices, different viewing angles, and technical metadata that a radiologist uses to make their interpretation. A printed report alone is not sufficient for a meaningful second opinion.

Step-by-Step: How to Request Your Imaging Files

  1. Identify where your imaging was performed. This is the facility you need to contact — not your referring doctor's office. If your primary care physician ordered a CT scan and you had it done at a hospital radiology department, contact the hospital.
  2. Call the radiology department or medical records office. Ask to speak with someone about obtaining a copy of your imaging files in DICOM format. Use that exact phrase — "DICOM files" — so they understand you want the images, not just the written report.
  3. Submit a medical records request. Most facilities have a form — either in person, by fax, or through their patient portal. You'll need to provide your name, date of birth, date of the study, and the type of imaging.
  4. Specify the format. Request a CD/DVD or ask if they offer a digital download. Many modern facilities now offer secure download links through their patient portal (Epic MyChart, athenahealth, and others commonly support this).
  5. Follow up if needed. Facilities are generally required to respond within 30 days under HIPAA, but many will provide files much faster — sometimes the same day or within a few days.

What If They Give You a CD?

Many facilities still provide imaging on a CD or DVD. This is perfectly fine — the disc contains your DICOM files in a folder, often along with a simple viewer program. When you upload your files for a second opinion, you can drag and drop the files directly from the disc.

Tip: If your computer doesn't have a CD drive, many USB CD/DVD drives are available for under $30. Alternatively, ask the facility if they can provide a digital download instead.

Can They Charge You for Your Records?

Under HIPAA, facilities may charge a reasonable cost-based fee for copying records, but they cannot deny you access. For digital files sent electronically, many facilities provide them at no charge. Physical media like CDs may have a small fee — typically $5–$25.

What If the Facility Refuses or Is Difficult?

Most facilities comply readily. If you encounter resistance, you can:

  • Ask to speak with the facility's HIPAA Privacy Officer
  • Reference your rights under 45 CFR § 164.524 (the HIPAA right of access rule)
  • File a complaint with the U.S. Department of Health and Human Services Office for Civil Rights if access is wrongfully denied

In practice, simply mentioning that you're aware of your HIPAA rights resolves most issues immediately.

Patient Portals Make It Easier Than Ever

Many large health systems now offer imaging downloads directly through their patient portals. If you're a patient at a system that uses Epic (MyChart), you may be able to download your DICOM files directly without making a phone call. Log into your patient portal, navigate to your visit records, and look for an option to download imaging or view your studies.

Once You Have Your Files

Once you have your DICOM files — whether from a CD, a download, or a patient portal — you're ready to upload them for a second opinion. Our platform accepts DICOM files directly, as well as common image formats like JPG and PNG for studies that were provided in those formats.