How To Prepare

The following items are very important to insure that your experience with Mobile On-site Mammography is a pleasant one. They will further insure that the results of your mammogram are processed in a timely and accurate fashion.

• Print and complete patient forms. See links below to print.
• Bring insurance card
• We will need your physician’s name, address and phone number. This provides for the timely submission of the results to your physician.

If applicable we need the name, address and phone number of the facility where you had your last mammogram. This is very important. It allows the Radiologist the ability to compare prior images with our images. It is only to your benefit to have your mammogram results read with as much information as possible.

• Do not wear any deodorant, powder, perfume or lotion the day of your appointment.
• It is suggested that a two piece outfit be worn the day of your appointment.

Remember, 15 minutes could save your life.

English Forms

1. Patient Information – English
2. Patient Mammography Form – English

Spanish Forms

1. Patient Information – Spanish
2. Patient Mammography Form – Spanish