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Convenient Online Mammogram Booking Requests

Mammogram Appointment Requests

EFW Radiology is proud to provide high-quality breast imaging services with compassionate, patient-centered care. Whether you are booking through Alberta’s self-referral screening program or have been referred by your healthcare provider, our experienced team is here to support you every step of the way.

This online service is for mammogram appointment requests only. Submitting this form does not secure an appointment.

Self-Referral Screening Mammograms: Eligible patients may submit an appointment request without a physician requisition.


Physician-Referred Mammograms: A completed requisition from your healthcare provider must be uploaded as part of your request.


Once your request has been received, it will be reviewed by our team, and a member of Central Booking will contact you as soon as possible to arrange an appointment.

If you require immediate assistance, please contact our Central Booking team at (403) 541-1200.

Please note: Patients requesting a physician-referred mammogram must upload their requisition to complete the online booking request. If you do not have a copy of your requisition available, please contact our Central Booking team for assistance.

Mammogram Appointment Request

Step 1

Contact Information

Is this self referral or a doctor’s referral

Step 2

Select exam and upload a photo of your physician-referred requisition form

No file chosen

*By uploading your requisition form you are giving EFW Radiology consent to collect this information under Part 3 of the Health Information Act.

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