Schedule a Mammogram

Use this form to schedule a mammogram online if you are a women age 40 or older with an average risk of developing breast cancer. If you are high risk for breast cancer, or have questions about mammograms, call (800) 436-7936.

  • Existing Henry Ford patients should request an appointment through MyChart
  • Log in to MyChart

Enter MM/DD/YYYY
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Are there at least 12 months between your last mammogram and the appointment you are scheduling? Most insurances require one year and one day (366 days) between appointments.

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Have you had any history of breast cancer within the past 2 years?

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Are you presently experiencing any breast problems such as new lumps, specific pain, discharge, etc.?

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Do you have breast implants or any special needs that may require additional time (e.g., wheelchair, mental impairment, group home patient, etc.)?

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