Phone: (973) 509-1818
Fax: (973) 509-0532
Directions: click here
When you call, we’ll schedule your appointment and ask for your contact information, phone numbers (work and cell) and email address.
Tips for First Time Patients
- Print and fill out the forms you need (below)
- Bring any prior mammogram or ultrasound films and reports with you. Request that these films and reports be mailed or faxed to us at (973) 509-0532. Print out the Request Film Release Form, complete it and mail or fax to the facility or facilities you have visited in the past. You should give the facility at least a week’s notice so that they have time to locate your films.
- To avoid surprises, find out what your insurance plan will cover. We are a fee-for-service center, which means that we do not participate with insurance plans. We will bill you for our services, and provide a receipt (and claim form) that you can use to file for reimbursement from your insurance company.
- Many of our patients receive some reimbursement under their “out-of-network” option.
- Bring your insurance card. We will need to make a copy for your medical records.
- You may be asked to remove your clothing from the waist up for an examination; we suggest wearing a top with a skirt or pants to your appointment to make changing easier for you.
- Please refrain from wearing deodorant or powder the day of your appointment, as they can interfere with results.
- Some of the time will be spent in registration and some of the time will be waiting for your digital mammogram to be thoroughly reviewed.
Being conscientious about your health is important. Congratulations on taking the first step to receiving care in an environment dedicated to the highest quality and to your comfort and concerns!
Montclair Breast Center has a new Risk Assessment Tool that will help us to categorize your risk and notify us if you are a candidate for Genetic Testing. Please click here: https://questionnaire.canceriq.com/#/134490ed-2105-49d8-8c78-be9647b11dfe Please complete the Risk Assessment prior to your appointment.
Please print out and complete the appropriate forms before your visit and bring them with you.
Click on the link below each form for a printable version.
Click to Download forms [PDF files]
- MBC Non Par Facility Acknowledgement
- Patient Rights
- Patient Questionnaire
- Individual Patient Authorization
- Bone Densitometry Questionnaire
- Request Film Release Form
- ABN Form for Medicare Patients (2017)
- Notice of Privacy Practices
Welcome to the Montclair Breast Center family!