Request an Account for Online Access to Reports and Images

Not for patient use. The information on this page is intended for use by referring physicians only.

Please complete the form below to request online access to the reports and images of patients you’ve referred to us. By submitting this form, you are acknowledging and accepting our Terms of Use that are detailed below. A member of our team will respond to you typically within 48 hours.

Alliance HealthCare Services, Inc. and its affiliates and subsidiaries (Disclosing Entity) authorizes You (Participant) access to its eRAD system (System) for treatment purposes related to patient management and care coordination.

By accessing the System, Participant agrees to use the System in a lawful manner which is consistent with the following Terms of Use:

(1) Participant shall comply with Disclosing Entity's guidelines regarding access to System. Participant shall also comply with applicable state and federal laws regarding patient privacy and confidentiality, including but not limited to the Health Insurance Portability and Accountability Act of 1996, as amended by the HITECH Act, and all applicable HIPAA Security Rule requirements (collectively, "HIPAA").

(2) Participant will not access, use or disclose patient information accessed through the System in a manner that would violate state or federal privacy laws, including but not limited to HIPAA.

(3) Participant is solely responsible for maintaining the privacy and security of their assigned log-in and password. Participant acknowledges that use of the access code or log-in information by unauthorized persons is prohibited. If Participant has reason to believe that the confidentiality of an access code or log-in information has been compromised, Participant will immediately contact Disclosing Entity and immediately request a change Participant's password and/or log-in.

(4) If Participant learns or has reason to believe that any person has made or attempted any unauthorized access to the System, Participant will immediately report this information to the Disclosing Entity.

(5) Participant understands and acknowledges that Participant is only authorized to utilize the System and the patient/medical records therein for the purposes set forth in the first paragraph of this Agreement to the extent permitted pursuant to HIPAA and applicable state and federal law ("Permitted Purposes"). At no time shall Participant utilize the System for any reason other than such Permitted Purposes. Participant acknowledges that Disclosing Entity may terminate access and seek such legal action and damages as may be allowable under applicable law and/or Disclosing Entity's policies and procedures for access not consistent with this Terms of Use.

(6) Participant is aware that Disclosing Entity has the right to audit Participant's access, with or without notice, and Participant expressly consents to such monitoring.

(7) Disclosing Entity reserves the right, at its sole discretion, to change, modify, add or remove portions of these Terms of Use at any time.