Mammography Appointment Request at Medical Center Downtown

If you need assistance completing this form or would like to schedule your appointment by phone, please call 319-339-3948 from 8 a.m. to 5 p.m. weekdays.

  • Personal History
  • Appointment Details
  • Complete

If you need assistance completing this form or would like to schedule your appointment by phone, please call 319-339-3948 from 8 a.m. to 5 p.m. weekdays.

Do you have an order for your exam?
Are you having a problem with your breasts?
Do you have a history of breast cancer?
Do you have breast implants?
Do you have a DEXA order to accompany your mammogram?
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