Skip to content
MGH Mammography Services
1.
In the past three years, have you had a mammogram? (For females ages 40–79)
Yes
No
Not Applicable
2.
If you answered “Yes” to having a mammogram in the past 3 years, was it completed at Montgomery General Hospital?
Yes
No
3.
If you answered “No” to having your mammogram completed at Montgomery General Hospital, was it completed at another local facility?
Yes
No
4.
If Montgomery General Hospital offered 3D mammography services, would you choose to have your mammogram completed there?
Yes
No
5.
Have you ever been diagnosed with breast cancer by a healthcare provider?
Yes
No
6.
Do you have a family history of Breast Cancer?
Yes
No
Unsure
7.
What is your 5-digit zipcode?