UK Parkside Hospital Mammography Request Form 2015-2025 free printable template

MAMMOGRAPHY REQUEST FORM Park side Hospital & Cancer Center London DEPARTMENT OF RADIOLOGY 53 Park side Wimbledon London SW19 5NX Telephone: 020 8971 8000 Fax: 020 8947 1526 Email: radiology parksidehospital.co.UK

How to fill out UK Parkside Hospital Mammography Request Form

How to fill out UK Parkside Hospital Mammography Request Form

1. Obtain the UK Parkside Hospital Mammography Request Form from the hospital's website or reception.
2. Fill in the patient's personal details, including full name, date of birth, and contact information.
3. Specify the reason for the mammography request; this could include symptoms or preventive screening.
4. Provide relevant medical history, including any prior breast issues or family history of breast cancer.
5. Include details of the referring physician, such as name, contact information, and signature.
6. Indicate preferred date and time for the appointment if applicable.
7. Review the completed form for accuracy and completeness.
8. Submit the form via the hospital's designated submission method, such as email, fax, or in-person delivery.

Who needs UK Parkside Hospital Mammography Request Form?

1. Patients who require breast cancer screening or diagnostic evaluation.
2. Referring physicians who need to request a mammography for their patients.
3. Individuals with a family history of breast cancer seeking preventive measures.
4. Women aged 40 and above who are eligible for regular screening mammograms.

People Also Ask about

How much does a mammogram cost out of pocket in the US?

A diagnostic mammogram is used to check for breast cancer after a lump or other sign or symptom of the disease has been found. This test includes the examination of both breasts. The national average cost for a diagnostic mammogram is about $499 without insurance.

Why am I getting a bill for a mammogram?

A diagnostic mammogram, however, is processed through your insurance company as a diagnostic exam, so you may have out-of-pocket expenses, based on your copay arrangement and whether or not you have met your deductible for the year.

How do I prepare for my first mammogram?

Prepare for your mammogram. If you haven't started menopause, schedule your mammogram for the week after your menstrual period. Schedule your appointment early in the day since you can't wear deodorant, powder, lotion or ointment around the chest area. Wear a two-piece outfit so you only have to remove your top.

What is the procedure for a mammogram?

You will stand in front of a special X-ray machine. A technologist will place your breast on a plastic plate. Another plate will firmly press your breast from above. The plates will flatten the breast, holding it still while the X-ray is being taken.

What is the cost of mammography?

Mammography Test Price and Centres Generally, a mammography test costs range from Rs 1500 to Rs 3000.

At what age should you get a mammogram?

Women should start getting regular mammograms at the age of 40, ing to a new recommendation being drafted by the U.S. Preventive Services Task Force. This is a reversal from the previous recommendation of age 50, which means more than 20 million women will now be considering mammogram screening.

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What is UK Parkside Hospital Mammography Request Form?

The UK Parkside Hospital Mammography Request Form is a medical document used to request a mammography procedure for breast screening or diagnosis.

Who is required to file UK Parkside Hospital Mammography Request Form?

The form is typically required to be filed by healthcare professionals, such as doctors or specialists, who are referring a patient for a mammography examination.

How to fill out UK Parkside Hospital Mammography Request Form?

To fill out the form, the healthcare professional should provide patient details, including name and medical history, along with the specific reason for the mammography request, and any relevant clinical findings.

What is the purpose of UK Parkside Hospital Mammography Request Form?

The purpose of the form is to formally document the request for a mammogram, ensuring that patients receive appropriate breast screening or diagnostic services as needed.

What information must be reported on UK Parkside Hospital Mammography Request Form?

The form must report the patient's personal information, referring clinician details, indication for the mammography, patient medical history, and any relevant imaging history.