Breast Cancer Risk Assessment

Breast cancer risk assessment

Do you have personal or family history of the following:

Please read this release form

By clicking submit you are agreeing to:

I hereby release MemorialCare Health System and other organizations associated with this Breast cancer risk assessment, parent company and all other employees and volunteers and any other individuals associated with the Breast cancer risk assessment or from any information provided at this Web site, from any and all liability which may arise. I understand:

  1. The risk assessment is not diagnostic and is not a substitute for an examination by a physician.
  2. The data derived from the risk assessment is to be considered as preliminary only, and in no way conclusive.
  3. The responsibility for any follow-up examination lies with me and not with any participating organization, employee, volunteer or individuals.
  4. I am responsible for my own health and it is my sole responsibility to follow through on any and all identified risk factors by obtaining appropriate medical attention and advice.