Abstract: A medical image exchange system connects a transmission system to an image relay server. The medical image exchange system includes a device configured to input a transmission destination of image data and select image data, in response to a request from the in-hospital terminal. The medical image exchange system includes a device configured to generate an image relay form including relay information on the transmission destination and information for identifying the selected image data. The image relay server transmits a request to acquire the image to the transmission system based on the image relay form. The image transmission system acquires the image in response to the acquisition request, and transmits the image to the image relay server.