Get Breast Screen Registration Form 2020-2025

Completing the Breast Screen Registration Form is an essential step in ensuring you receive proper screening for breast health. This guide will provide you with a clear, step-by-step approach to filling out the form online, helping to ensure that all necessary information is accurately captured.

Follow the steps to complete your registration form online.

1. Press the ‘Get Form’ button to access the Breast Screen Registration Form and open it in your online editor.
2. Start by filling out your title in the designated area. Options include Mrs, Miss, or Ms.
3. Enter your surname and given names in the appropriate fields. Ensure accuracy as this information is crucial for identification.
4. Provide your date of birth and indicate your age at your last birthday.
5. Complete your home address and postal address if it differs from your home address. Include your postcode in both sections.
6. Fill out your contact details, including home, work, and mobile phone numbers, as well as your email address if applicable.
7. Indicate whether you speak a language other than English at home and specify the language if applicable.
8. Answer questions related to your medical history, including previous mammogram experiences and family history of breast cancer.
9. Complete the sections regarding any current breast symptoms, previous breast cancer history, and use of hormone replacement therapy.
10. Review the consent section, read the provided information, and sign to confirm your understanding and agreement with the terms outlined.
11. Once you have completed all sections of the form, save your changes and proceed to download, print, or share the form as necessary.

Begin filling out your Breast Screen Registration Form online today to ensure your health screening is scheduled promptly.