CARE Clinic Eligibility Questionnaire
Take this assessment to see if you meet the criteria to be seen at the CARE Clinic.
1. Do you have a first-degree relative (parent, child, or sibling) under the age of 50 with a diagnosis of breast cancer?
2. Do multiple family members have breast and ovarian cancer?
3. Are you of Ashkenazi Jewish decent?
4. Do you have a parent, child, or sibling with a genetic mutation associated with Breast Cancer?
5. Do you have a male family member diagnosed with breast cancer?
6. Have you had chest radiation treatment between the ages of 10 to 30?
You appear to meet guidelines forHigh Risk CARE Clinic.
We evaluated your personal and/or family history and risk factors and believe that you may be a candidate for the CARE Clinic.
or call us at 305-689-CARE (2273)
Based on this information, you do not meet the criteria for the CARE Clinic at this time.
Please address any concerns you may have with your primary care provider.