The Office of Health Communications and Health Disparities

For more information about mobile services or to arrange a screening, contact Linda Hammell at 215-728-3554 or Linda.Hammell@Fccc.edu

Risk Assessment at Fox Chase

Risk Assessment at Fox Chase

Learning what you can do to lower your chances of getting cancer.
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Learn Your Cancer Risk

Learn Your Cancer Risk

Determine Your Cancer Risks.
Read more »



Printable Required Forms

Mobile mammography staff

Mobile Mammography Staff

If you either plan to participate in the program or have already scheduled a visit from the mobile mammography van, the following forms are necessary to read and complete.

The links below require Adobe® Acrobat Reader to view.

  • Corporate Client Guide
    [PDF] | [DOC]
  • Survey Letter for Eligibility Requirements [PDF] | [DOC]
  • Health History Questionaire
    [PDF] | [DOC]

    Note: Must be a one-page double-sided document.
  • Demographic Questionnaire [PDF] | [DOC]
  • Authorization To Obtain Previous Mammography Films [PDF] | [DOC]