Use our online form to request an appointment for a mammogram. Please note that this is only an appointment request. One of our customer care agents will contact you to schedule your appointment according to your preferred date, time & location and based on availability.
Early detection saves lives. Request your annual mammogram today.
To request a mammogram, please fill out the form below or call 860.291.6569
Please select your preferred time and up to two (optional) alternate times in case your preference is not available.
* Note that ALL fields are required unless otherwise noted.