Committed to providing the most convenient methods to fulfill your health care needs, The Elaine M. Junca Women's Imaging Centre offers Online Pre-Registration and Mammogram Scheduling.
Simply complete the 10-20 minute Online Pre-Registration and Mammogram Scheduling forms at least three (3) business days prior to your scheduled appointment. For privacy reasons, if you leave your computer idle for more than 20 minutes, your form will not be saved and you will have to begin again.
Before you begin, be sure you have all of the information listed below.
- Social Security Number
Disclosure of your social security number (SSN) is requested from you. No statute or other authority requires that you disclose your SSN for this purpose and we may not deny services if you choose not to disclosure it. Failure to provide your SSN, however, may result in the creation of a duplicate medical record.
- Name of ordering physician
- Date of your scheduled procedure
- All insurance cards information
- Employer information
Check-in with our registration staff on the date of your scheduled service to complete the registration process. Please be advised that you will sign all consent forms during your visit.