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WV Breast and Cervical Cancer Screening Program Client Enrollment Form WEBCAST Enrollment Facility: ___ WEBCAST #: ___Enrollment Date (mm/dd/YYY): ___ /___ / ___Social Security #: ___ ___ ___Date

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How to fill out breast and cervical cancer

01

Get a referral from a healthcare provider for a breast and cervical cancer screening.

02

Schedule an appointment at a screening facility.

03

Arrive at the screening facility at the scheduled time.

04

Fill out any necessary paperwork provided by the facility.

05

Follow the instructions given by the healthcare provider during the screening process.

06

Await the results of the screening.

Who needs breast and cervical cancer?

01

Women are typically the ones who need breast and cervical cancer screenings as they are at higher risk for developing these types of cancers.

02

People with a family history of breast or cervical cancer may also be advised to get screened.

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What is breast and cervical cancer?

Breast and cervical cancer are types of cancer that affect the breast and cervix, respectively.

Who is required to file breast and cervical cancer?

Healthcare providers and facilities are required to file reports on cases of breast and cervical cancer.

How to fill out breast and cervical cancer?

Healthcare providers can fill out reports on breast and cervical cancer by providing relevant patient information and details on the diagnosis.

What is the purpose of breast and cervical cancer?

The purpose of reporting on breast and cervical cancer is to track and monitor the incidence of these diseases in order to improve prevention and treatment strategies.

What information must be reported on breast and cervical cancer?

Information such as patient demographics, tumor characteristics, and treatment details must be reported on cases of breast and cervical cancer.

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