Schedule Your Screening Mammogram

In accordance with recent Society of Breast Imaging guidelines, consider scheduling your screening mammogram BEFORE your first COVID-19 vaccination, or 4 weeks AFTER your 2nd dose, if possible. If you have questions, please call 626.698.7266.

Step 1: Please answer the following questions so we can determine which mammography service will best meet your needs.
1. Is this a follow up to an abnormal mammogram?(Required)
Based on the information you provided, a diagnostic mammogram may be recommended. Please call us at 626.698.7266 to schedule your appointment.
2. Are you having any breast symptoms, such as lumps, breast infection, pain or nipple discharge?(Required)
Based on the information you provided, a diagnostic mammogram may be recommended. Please call us at 626.698.7266 to schedule your appointment.
3. Have you been diagnosed with breast cancer within the last two years?(Required)
Based on the information you provided, a diagnostic mammogram may be recommended. Please call us at 626.698.7266 to schedule your appointment.
Step 2: Request your screening mammogram appointment
Name(Required)
1. Has it been at least a year since your last screening mammogram? Note: Your insurance company may not cover the cost of a screening mammogram if it has been less than a year since your last one.
2. Are you using insurance for this appointment?
3. Who is the ordering/referring physician?
Practice Name
MM slash DD slash YYYY
Other location
6. Does your order specify, or would you like to upgrade your mammogram to use 3D technology?
7. Do you require additional assistance at the time of your appointment? (I.e., wheelchair, or motorized chair dependent)
8. Which location(s) do you prefer? Select all that apply.
9. What part of the day would you prefer to schedule your appointment? Select all that apply.
Specific Timeframe:
10. What days would you prefer to schedule your appointment? Select all that apply.
11. What is the best way to confirm your appointment?
This field is for validation purposes and should be left unchanged.
en English
ar Arabiczh-CN Chinese (Simplified)nl Dutchen Englishfr Frenchde Germanit Italianpt Portugueseru Russianes Spanish
This website uses cookies to improve your experience. If you continue to use this site, you agree with it. Privacy Policy