Mammogram request form 2025

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The document is a Mammography Request Form from Parkside Hospital & Cancer Centre in London, designed for the Department of Radiology. It collects essential patient and referring doctor information, clinical history, examination requests, and specific questions to be answered. The form emphasizes the need for complete submissions to avoid delays and includes sections for radiographer use.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can you just go get a mammogram?

Women over 40 who are not experiencing symptoms can make an appointment for their annual mammogram on their own. Annual mammograms are the best tool for early detection of cancer. Most cancers detected by mammography have no symptoms.

How do you ask for a mammogram?

Speak with your primary care doctor or ob-gyn about your risk and a plan for screening. Regardless of your risk factors, if you feel a lump in your , schedule a mammogram immediately, no matter your age.

Can I request my mammogram images?

Contact your previous imaging center or hospital and request your prior mammograms. You will likely have to complete a medical release form, if you havent done so already. You can usually have them mailed to you or directly to Clermont Radiology (871 Oakley Seaver Dr.

Can you request a mammogram at any age?

The USPSTF guidelines differ from American Cancer Society (ACS) guidelines, which recommend optional annual screening for women ages 40 to 44, annual screenings for those 45 to 54, and a choice of annual or biennial screening for women 55 and older as long as they are in good health and expected to live 10 years or

Are mammograms free in California?

The Every Woman Counts program provides free and cervical cancer screening and follow-up services. This includes clinical exams, mammograms, and Pap tests to eligible women in California.

How do I schedule my first mammogram?

Schedule Your Mammogram To schedule by phone, call 1-844-240-7092. By learning how to prepare for and what to expect from this important cancer screening exam, you can eliminate some of the guesswork. And, that can make your experience less nerve-wracking.

Can you request a mammogram?

You need a doctor or doctors order to schedule this exam. If you already have a doctor and the mammography facility requires a doctors order, be sure and let you doctor know that you need to schedule a mammogram, as well as any unusual symptoms that you are experiencing.

Mammogram request form 2025

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