Request an appointment

Request a Breast Screening Appointment

Complete the form below to request a breast screening appointment.  Fields marked with an asterisk (*) require to you enter the relevant information before the request can be send to BreastScreen Tasmania.

Date of Birth *

(if known)		        
Appointment Location

If you select mobile unit, please enter your preferred mobile unit location in the Comments field at the end of this form. view mobile unit itinerary (dates and locations)                
Preferred days
Preferred appointment times

    An email confirmation will be sent to the email address you supplied above.