Services

Welcome to Saint Vincent Health System's online appointment system. At this time, this service is only for scheduling routine mammogram screenings. If you would like to schedule any other services, please call Centralized Scheduling at 814/866-4850. Submission of this form does not guarantee an actual appointment time. You will receive a phone call within two business days confirming your appointment date and time. Our scheduling office is open Monday through Friday 8am to 5pm.

Patient Information

Indicates a required field

First Name

M.I.

Last Name

Street Address

Apt/Suite/Bldg

City

State

Zip

Home Phone

Work Phone

Other Phone

Gender

Date of Birth

Physician Information

Physician Name

Insurance Information

Primary Insurance Name

Employer Name

Appointment Information

Indicates a required field

Best time to contact

Is it okay to leave message?
Yes
No

Please schedule my appointment

First Choice Date

Second Choice Date

Do you need extra assistance (i.e. wheelchair, oxygen, etc.)?
Yes
No

Saint Vincent

Mammogram Appointment Request › The Saint Vincent Women's Center › Services

Patient Information

Physician Information

Insurance Information

Appointment Information

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