Florida Radiology Consultants-Patient Concierge Service

At FRC, we understand the needs of our patients and that is why we are pleased to offer a first of its kind service to our patients! Simply fill out this request, and FRC will arrange the delivery of your films or preparation materials to your home or office within Lee County with no delivery charge.
*Standard charges apply for film/CD/and some preparation materials. We will need 24 hours advance notice for this service.

*Required

Your e-mail address:

Patient Information:
*First Name: *Last Name:
*Date of Birth: (ex:00/00/1900) *Patient Daytime Phone#: (EX: 239-000-0000)

Delivery Information:
*Delivery Location: Home Other
*Delivery Street Address:
*City: *Zip Code:
Special Delivery Instructions:
I authorize the release of contrast and/or prescription to:

Supply Information: (check all that apply)

Barium Contrast (Free)
Film ($8.00/sheet)
CD ($35.00 each)
Report ($0.25/sheet)
Phospho-Soda ($4.25)
Prednisone Prescription
Creatinine Prescription

A member of our staff will call you during our normal business hours, Monday through Friday 7:30AM to 5PM.
If you need to reach us by phone, please call 239-938-3535.