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Mammogram Appointment Request

 

Solicitud de cita para una mamografía

Use this form to request an appointment for a Mammogram at our Women's Diagnostic Center. Our staff will contact you within 48 hours to confirm it.

In order for your physician to determine the appropriate type of mammogram, you should consult with him/her BEFORE scheduling a mammogram IF you:

  • Have had any breast surgery or biopsy; OR
  • Have any of the following symptoms: breast pain, breast lumps, any discharge

If none of the above apply please complete this form and click "Submit".

Utilice este formulario para solicitar una cita para su mamografía en nuestro Centro de Diagnóstico para la Mujer. Nuestro personal la contactará dentro de 48 horas para confirmarla.

Para que su médico pueda determinar el tipo de mamografía que es apropiada, consúltele ANTES de agendar su cita SI usted:

  • Ha tenido alguna cirugia del seno, una biopsia o
  • Tiene alguno de los siguientes síntomas: dolor, un bulto o supuración en el seno.

Si ninguno le aplica, llene este formulario y presione "Submit" para enviarlo.

* Denotes required fields
* Do you have breast implants?
* When is the best time to get a hold of you?
* Ok to use e-mail communication to schedule appointment dates and times with you?

Tri-City Medical Center

760-724-8411 4002 Vista Way, Oceanside, CA 92056 Contact Us