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Mammography Patient History Sheet CLINICAL HISTORY Last Breast Exam: Findings: Yes No Parity (by: Date: Interviewer: Baseline mammogram? Location : Date: Currently menstruating? LMP: Age at monarch:

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What is mammography patient history sheet?

Mammography patient history sheet is a form that captures the medical history of a patient undergoing a mammogram.

Who is required to file mammography patient history sheet?

Healthcare providers or facilities conducting mammograms are required to file the mammography patient history sheet.

How to fill out mammography patient history sheet?

The mammography patient history sheet is typically filled out by the patient or with the assistance of a healthcare provider, providing details about their medical history, current symptoms, and any previous mammogram results.

What is the purpose of mammography patient history sheet?

The purpose of the mammography patient history sheet is to provide the healthcare provider with important information about the patient's medical history that may impact the interpretation of the mammogram results.

What information must be reported on mammography patient history sheet?

The mammography patient history sheet typically includes information such as the patient's personal details, medical history, family history of breast cancer, current symptoms, and any previous mammogram results.

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