Call us today (954) 791-9729
Home
Appointments
About Us
Exam Preparation
Insurance Carriers
Forms
Record Request
Records Request Form
If you would like to requests you records from current or previous companies, please fill out the form bellow. We will contact you when your records become available.
Name
*
Date of Birth
*
MM
/
DD
/
YYYY
Address 1
Address 2
City
State
Zip Code
Best Contact #
*
Email
A description of the section goes here.
Exam Requested
*
Mammogram
Ultrasound
X-Ray/ Fluoroscopy
MRI
CT Scan
Bone Density
If you received a coupon code please enter it here
Special Instructions
Image Verification
Please enter the text from the image
:
[
Refresh Image
][
What's This?
]
Schedule Your Appointment Today!
RDC Plantation Inc.
7050 NW 4th Street #202
Plantation, FL 33317
T: (954) 791-9729
F: (954) 791-9724
Certified Facility
Tell us what you think!