New Horizons Imaging

Clinician Image Transfer Request

Request the secure transfer of MRI images and/or reports to an authorised clinician, clinic, PACS administrator or radiology team.

Please ensure all required recipient email addresses are included. Once a secure Egress transfer has been sent, additional recipients cannot be added.

Complete Request Form

Before you begin

Patient name and date of birth
Date of scan or NHI reference
Body part / exam area scanned
Recipient clinic details
Authorised recipient email address

Secure DICOM Image Transfer

Submit your image transfer request

Complete the form below and the NHI team will review your request before securely transferring the required MRI images and/or report.

Patient Details

Please complete the patient's details exactly as recorded.

Full Name(Required)

Date of Birth(Required)

Patient Contact Number(Required)

NHI Scan Reference (if known)

Date of Scan(Required)

Exam Area / Body Part Scanned(Required)

Transfer Request

Select whether you require the MRI images, the report, or both.

Transfer Request(Required)

MRI Images

MRI Report

Recipient Clinic Name(Required)

Authorised Recipient Name(Required)

Recipient Contact Number(Required)

Primary Recipient Email(Required)

Additional Recipient Email Addresses

Patient Consent(Required)

I confirm that I am authorised to request this transfer and that the information provided is accurate. I understand the transfer will be sent securely using Egress Secure Mail.

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