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SPOKANE REGIONAL HEALTH DISTRICT PHONE 5093232851 FAX 5093241599 WWW.RHD. Breast and Cervical Risk Assessment Form One Paged OH 349043 Nov 2019 Please PrintBCCHP ID#Last Name:First Name:Clinic/Screening
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How to fill out breast ampamp cervical historyexamscreening

01
To fill out breast and cervical history exam screening, follow these steps:
02
Begin by gathering all relevant medical records, including any previous mammograms or Pap smear results.
03
Make sure you have a copy of the breast and cervical history exam screening form, which can be obtained from your healthcare provider or online.
04
Start by providing personal information such as name, age, contact details, and healthcare provider.
05
Fill in the medical history section, including any past or current breast or cervical conditions, surgeries, or treatments.
06
Answer questions related to family history of breast or cervical cancer, genetic predisposition, or any known risk factors.
07
Provide details about any medications, allergies, or ongoing treatments that may be relevant to the screening.
08
If applicable, mention any previous screening dates and results.
09
Complete the form by signing and dating it, acknowledging that the information provided is accurate to the best of your knowledge.
10
Submit the form to your healthcare provider or follow their instructions for further submission.
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Keep a copy of the filled form for your records and future reference.

Who needs breast ampamp cervical historyexamscreening?

01
Breast and cervical history exam screening is recommended for:
02
- Women above a certain age (usually starting from 40-50 years old) for breast cancer screening
03
- Women with a history of breast or cervical conditions
04
- Women with a family history of breast or cervical cancer
05
- Women with known risk factors for breast or cervical cancer
06
- Women seeking routine preventive healthcare and early detection of any potential issues
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Breast and cervical history exam screening is a medical procedure that involves examining a woman's breasts and cervix for any abnormalities or signs of disease.
Women of certain age groups or risk factors are required to undergo breast and cervical history exam screening.
To fill out breast and cervical history exam screening, a woman needs to visit a healthcare provider who specializes in women's health.
The purpose of breast and cervical history exam screening is to detect any potential health issues, such as breast cancer or cervical cancer, at an early stage for better treatment outcomes.
Information regarding the patient's medical history, previous screenings, family history of cancer, and any symptoms or concerns should be reported on breast and cervical history exam screening.
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