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Request a Mammogram Appointment

Thank you for requesting a mammogram at one of Northwestern Medicine Lake Forest Hospital's five locations.

Please complete the fields below and submit. Your request will go to a scheduler who will contact you by email or phone within one business day during regular business hours, Monday to Friday.

Please note: this appointment request is not for emergencies, same day or next day appointments. If you need an appointment within the next 48 hours, please contact us directly at 847.535.8000.

This appointment request form requires you to answer confidential health information that is needed to complete your request and shall be used only for the purpose of helping you secure an office visit. Your personal information will not be shared with any party outside of Northwestern Medicine Lake Forest Hospital.

 

*required information
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How do you prefer we contact you?*


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Are you scheduling a screening or diagnostic mammogram?*


If you are requesting a diagnostic mammogram, do you have a referral from your physician?


Have you had a mammogram at Northwestern Medicine Lake Forest Hospital before?*


Preferred Location(s)
(Check all that apply.)*





Which time(s) of the day would you prefer your appointment?
(Check all that apply.)*




Which day(s) of the week would you prefer your appointment?
(Check all that apply.)*






Learn more about Imaging (Radiology)

 

Just in Time: Mammogram Saves Woman's Life

Finally putting her health needs first meant diagnosing breast cancer before it was too late more >

Seeing Imaging Facts Clearly

Get the straight answers on imaging questions, from mammogram guidelines to radiation exposure from CT scans more >

Help Stop Cancer-Support Our New Stereotactic Breast Biopsy Units

Stereotactic breast biopsy units are essential for local women's health more >

Better Alternative to Varicose Veins

Look and feel better with interventional radiology treatment options more >

 

Healthy Women Face Breast Cancer

Local women share their experiences and stories of breast cancer survival more >

Request a Mammogram Appointment

Request a mammogram at one of our six locations, and we will respond with an appointment within one business day more >

Request an Ultrasound Appointment

Request an ultrasound at one of our five locations, and we will respond with an appointment within one business day more >

 
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Northwestern Memorial
312.926.2000
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Central DuPage
630.933.1600
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Lake Forest
847.234.5600
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Delnor
630.208.3000
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Kishwaukee
815.756.1521
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Valley West
815.786.8484
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Patient Rights and Website Policies       
Accessibility      
© 2021 by Northwestern Medicine® and Northwestern Memorial HealthCare. Northwestern Medicine® is a trademark of Northwestern Memorial HealthCare, used by Northwestern University.
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Northwestern Memorial
312.926.2000
Central DuPage
630.933.1600
Lake Forest
847.234.5600
Delnor
630.208.3000
Kishwaukee
815.756.1521
Valley West
815.786.8484

Patient Rights and Website Policies       Accessibility
© 2021 by Northwestern Medicine® and Northwestern Memorial HealthCare. Northwestern Medicine® is a trademark of Northwestern Memorial HealthCare, used by Northwestern University.
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