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Request a Mammogram Appointment

 

Following the American Cancer Society guidelines, women are advised to have a screening mammogram every year after their 40th birthday. Most health insurance plans cover mammography expenses. Financial counseling is available for those without insurance.

If you are interested in scheduling a screening mammogram, please complete the form below. A representative will contact you within 2 business days to collect additional information and arrange your appointment. If you need urgent medical attention, please contact your physician or call the Providence Resource Line for a referral, at: 503-574-6595.

Questions and Contact Information (Fields marked with * are required)
Full Name*
Date of Birth*
City
Phone Number*
Best Time to Reach You*
E-mail Address*
Physician's Name
Preferred Location Providence Portland Medical Center
Providence St. Vincent Medical Center
Providence Milwaukie Hospital