Imaging Review Form

You may submit your MRI, CT and angiography studies together with your laboratory and pathology reports using the form below. Please complete all required fields.

1 Patient Details

Please enter the patient's personal details.

Type of submission *

I am sending reports or images for the first time I am a follow-up patient

Full name *

Date of birth *

Sex *

Country *

Province *

Email *

Email 2

Telephone *

Telephone 2

2 Imaging Files

Please upload the studies in DICOM format, as an archive. Image files are required, not written reports.

Upload studies — MRI / CT / Angiography *

Photographs may be selected directly. Images taken with your telephone (JPG, PNG, HEIC) are accepted without any need to compress them. If you have a DICOM CD, you may also send the folder as a .zip or .rar archive. More than one file may be selected.

Upload reports — imaging report, discharge summary and/or pathology

PDF, photograph or Word documents may be uploaded. More than one file may be selected.

Having difficulty uploading your studies?

You may download your studies in DICOM format from e-Nabız, or compress and upload the image folder from the CD provided by the hospital. Should you need assistance, you may contact us on WhatsApp.

3 Medical History

Please state any treatment you have received previously.

Have you undergone any operation? *

Yes No

Have you received chemotherapy? *

Yes No

Have you received radiotherapy? *

Yes No

Please list the operations you have undergone

Please list the medication you are taking

4 Symptoms and Notes

Please describe your symptoms and anything you wish to ask.

What are your symptoms? *

What would you like to ask the physician?

I have read the Data Protection Notice and consent to the processing of my personal and health data for the purposes of this submission. *