Buddy Bus Patient Registration - Florida Blue Center

Thank you for choosing the Baptist MD Anderson Cancer Center's Buddy Bus for your annual mammogram. Once this form has been submitted, you can expect a phone call from our scheduling team one week before the scheduled event.


EVENT TIME: 9:00 a.m. - 1:00 p.m.

EVENT DATE:

  • Saturday, February 8, 2025
  • Saturday, April 5, 2025
  • Saturday, May 10, 2025
  • Saturday, June 21, 2025
  • Saturday, July 12, 2025
  • Saturday, August 9, 2025
  • Saturday, September 20, 2025
  • Saturday, November 8, 2025
  • Saturday, December 13, 2025

EVENT LOCATION: 4855 Town Center Pkwy, Jacksonville, FL 32246



Questions?

Please contact BuddyBus@bmcjax.com



This form will take 5 minutes to complete.

 

Patient Information

 
 
 
 
Phone
 
 
 
 

(Street, City, State, and Zip code)

 
 
 
 

Insurance Information

 
 

Mammography Questionnaire

 
 

According to the American College of Radiology, pregnant patients can receive screening mammograms.

Pregnant women under the age of 30 at high risk for breast cancer, pregnant women age 30 to 39 at medium or high risk for breast cancer, and pregnant women 40 and older should receive screening mammography with lead shielding to minimize radiation exposure to the fetus.

Feb 27, 2019

 
 

Provider to send results to: