We have placed many of our medical forms here for your convenience. Before your appointment at The Breast Center of Greensboro Imaging, you may download, print, and complete these forms.

Be sure to bring them, signed and ready, when you arrive for your appointment. Filling out these forms in the privacy of your home can save you time and effort when you arrive at our center for your imaging procedure.

We have also provided some post-procedure guidelines for your convenience.

*You will need Acrobat Reader to download these forms.
If you do not have it, you may get a free download here.

All patients will need to fill out these forms If you are having a mammogram:

Notice of privacy practices
Receipt of privacy practice
Patient History Sheet

Release of information, mammography
If you are having a needle biopsy: If you are having bone density screening (DEXA):

Post biopsy instructions

Bone density screening
DEXA release
Release of information, bone density
Wire Localization Brochure of Services

Wire localization instructions

The Breast Center of Greensboro Imaging brochure


Greensboro Imaging
works with most major insurance companies to file your claims. If you aren’t sure of the extent of your coverage, we recommend you contact your insurance company for information about your policy.

For your convenience, we’ve listed the insurance companies, linked you to their website whenever possible and provided telephone numbers.
Your privacy is important to us we invite you to view our privacy policy

Aetna - All Plans www.aetna.com 888-632-3862
Blue Cross Blue Shield of N C - All Products www.bcbs.com 877-258-3334-NC
  800-487-5522-Out of State
  800-422-4658-State
    800-222-4739-Federal
BeechStreet www.beechstreet.com # on Card
Carolina Steel/Hierschfeld Steel Network   800-840-2161
Champus www.healthnetfederalservices.com 877-874-2273
Cigna Health Plans - All Products www.cigna.com 800-882-4462
Corvel/Corcare www.corvel.com 800-365-5998
First Health www.firsthealth.com # on Card
HealthCare Savings www.healthcaresavings.com # on Card
Health Care Sharing Inititive    
iNETICO    
Mamsi www.mamsi.com 800-267-6458
Medcost www.medcost.com # on Card
Medicaid   800-688-6696
Medicare www.medicare.gov 866-655-7996
Partners Medicare Choice www.partnershealth.com 760-4822
PHCS www.phcs.com # on Card
Railroad Medicare www.palmettogba.com 877-288-7600
United Healthcare Inc. www.uhc.com 877-842-3210
United Healthcare Medicare    
United Healthcare NC    
WellPath Preferred www.coventryhealth.com  
WellPath Select    
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