This questionnaire is to schedule a routine mammography screening performed at our Montgomery Street location in San Francisco, California. The address is 1725 Montgomery Street, 2nd Floor, Suite 250.
Do you have a referral from your provider?
A referral is a physician’s order. In this case, your doctor will have provided with a paper order requesting you have a mammography exam. If your provider is within the UCSF system, he or she will generate an electronic order.
We will need a referral from your provider to schedule you for a screening mammography. At this time, we are unable to complete this request. Please contact your provider for a screening mammography referral.