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Thank you for scheduling a screening mammogram at Houston Methodist Breast Care Center at Sugar Land. As a last step, please complete this form if you do not have a doctor’s order.
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Houston Methodist Breast Care Center at Sugar Land is authorized to accept self-requesting screening mammography without a doctor’s order if you answer “True” or “Not applicable” for the questions below. If you answer False to any of the following questions, you will need to obtain a physician order to schedule.