Get the free MD IMAGING MAMMOGRAPHY QUESTIONNAIREdoc

MAMMOGRAPHY QUESTIONNAIRE NOTE: If you have applied any deodorant or powder, please inform the technologist. Name: DOB: Age: Referring MD: Date: Ethnicity: Have you had a mammogram before? Yes No

How to fill out md imaging mammography questionnairedoc

How to Fill out MD Imaging Mammography QuestionnaireDoc:

1. Start by carefully reading the instructions provided with the questionnaire. Make sure you understand the purpose and the different sections of the document before proceeding.
2. Begin by filling out your personal information accurately. Provide your full name, contact details, date of birth, and any other necessary information as requested.
3. Move on to the medical history section. Answer the questions regarding past surgeries, medical conditions, allergies, and any medications you are currently taking. Be thorough and provide as much detail as possible to ensure accurate assessment.
4. Next, you may encounter questions related to your family history of breast cancer or other relevant medical conditions. If applicable, provide the necessary information, including the age at diagnosis and relationship to you.
5. Some questionnaires may ask about your reproductive history, such as previous pregnancies, breastfeeding, and menopausal status. Answer these questions accurately to assist in the interpretation of your mammography results.
6. If you have had previous mammograms, be prepared to provide details about the dates, locations, and results. This information helps in comparing images and identifying any changes over time.
7. Lastly, you may be asked about any specific symptoms or concerns you are experiencing regarding your breasts. This information helps healthcare professionals in identifying any additional tests or evaluations that may be needed during the mammography.

Who needs MD Imaging Mammography QuestionnaireDoc?

1. Patients scheduled for a mammography screening at MD Imaging facilities.
2. Individuals with a personal or family history of breast cancer or other breast-related medical conditions.
3. Patients experiencing specific breast-related symptoms or concerns.
4. Women of an appropriate age for routine mammography screenings, as recommended by their healthcare provider and national guidelines.

Remember, it is essential to consult with your healthcare provider if you have any doubts or questions while filling out the MD Imaging Mammography QuestionnaireDoc.

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