MASS GENERAL IMAGING - BOSTON
Screening Mammogram Appointment Request Form
Mass General Imaging - Boston
Wang Building - Room 240
Boston, MA 02114
Use this secure form to submit an appointment request for a screening mammogram.
We will contact you to schedule your appointment.
For questions or help with this form please call
Mass General MRN#
( Skip part B if you already have an MRN Number )
Date of Birth:
Date of last mammogram:
Preferred Appointment Day/Time:
Select a Preferred Day
Select a Preferred Time
Evening - Monday thru Thursday Only
(Max length of 200 characters)
Results should be sent to:
Physician's Full Name:
Best time to reach you:
Select a Time
Morning (8:00 AM - 11:00 AM)
Afternoon (12:00 PM - 3:00 PM)
Evening (4:00 PM - 5:00 PM)
Mass General Imaging - Boston performs
3D mammography (tomosynthesis)
, a newer technology pioneered at Mass General that promises better breast-cancer detection and fewer callbacks.
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