Pink Days: Free Mammogram Program

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Pink Days: Free Mammogram Program

John Stoddard Cancer Center, a service of UnityPoint Health – Des Moines, has partnered with Bras for the Cause, Iowa Lutheran Hospital and Iowa Radiology to offer Pink Days. Pink Days is a FREE mammogram for uninsured and underinsured women in the Des Moines area.

To qualify for the program, a patient must meet the following criteria:

Please check if the patient qualifies for this program.

Patient is female.Patient is 40 years old or older.Patient has an income at or below 250% of the federal poverty income level.Patient has no insurance or insurance that does not cover these services, and no Medicare Part B coverage.

Patient Information

If you meet the above qualifications and would like to be contacted by our team to discuss your eligibility and submission, please complete the following details.

First Name

Last Name

Phone number

Secondary phone number

Email Address

What IA county do you live in?

Are you 40 years old or older?

YesNo

Do you have medical insurance? (Includes Medicare, Medicaid, high deductible or health savings accounts)

YesNo

Have you ever had a mammogram?

YesNo

What was the date of your last mammogram?

What is the best time of day to reach you?

8 a.m. to 12 p.m.12 p.m. to 4 p.m.4 p.m. to 8 p.m.Other

My preferred time is:

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