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    Referrer Resources‎ > ‎

    Request Web Server Access


    Request Web Server Access


    To obtain access to our web PACS server, we need you to complete a document that outlines and acknowledges our commitment to patient confidentiality and privacy in accordance with HIPAA statutes. 

    Fax Request:

    Please click on the attachment below, print and fill out the form, and submit by faxing to the number provided on the form. 

    Password Request / Confidentiality Agreement

    Online Request:

    DR Password Request and Confidentiality Agreement




    We will have your access confirmed and in place within 24 hours.

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