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For Physicians

Breast Cancer Awareness, Inc. is committed to ensuring that uninsured individuals in our service area have access to essential breast cancer screening services. To better serve your patients, we’ve updated our waiver form and program guidelines. This program is specifically designed to cover the cost of a patient’s annual mammogram and, if necessary, a second “call-back” mammogram or ultrasound.

Please carefully review the following steps to ensure compliance and timely processing of imaging services. Your cooperation is crucial in helping us provide these vital services to those in need.


Download Waiver Request Pink Cards

Forms MUST be faxed by referring physician’s office:

Fax 301-797-4090
12916 Conamar Dr.
Hagerstown, MD 21742

Patient Guidelines

  • The program is only available for individuals that do not have insurance and
  • Live in our service area (Frederick and Washington Counties in Maryland; Franklin and Fulton Counties in Pennsylvania; and Berkeley, Jefferson, and Morgan Counties in West Virginia).