Mammobus Screening @ SCS Women's Gynaecological Cancer Healthy Work Out 29th and 30th Jun(Fully Booked)
Thank you for your interest to screen. We are fully booked on 30th Jun and looking to open an additional day on 29th Jun

Please fill up the form and allow us to follow up with you with a phone call and text message

Application Process
Step 1: Complete this registration form.
A check would be done on the Breast Screen Singapore(BSS) System to determine your eligibility to screen and fee applicable (subsidies and funding assistance)

Step 2: The organisers will give you a call, text and/or email to inform you of your appointment time and fees payable (if any) and things to take note before screening

Step 3: Attend Mammogram Screening. Please arrive about 15 mins early

Step 4: Your mammogram results will be send to you via post with a month.

Please indicate your preference for timeslots (Please note that our 30th Jun screening is fully subscribed) *
A mammogram screen would take about 15 to 20 mins. After verifying your eligibility, we will inform you of the time of your appointment and fees payable (if any)
Personal Particulars
NRIC *
We require you NRIC to verify your eligibility for screening and subsidies on Breast Screen Singapore
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Salutation *
Eg. Dr / Mrs / Ms / Mdm
Surname / Last Name *
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First Name *
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Mobile Number *
We require your mobile to send confirmation and reminder messages
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Email
We require your email to send confirmation and reminder messages
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Address
Postal Code
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Unit Number
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Street Name
Please key Block and Building Names here.
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My Race is
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I learnt about this event from *
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I wish to be informed of future SCS & BCF programmes and activities *
Personal Data
By completing this form, I consent to allow Singapore Cancer Society (“SCS”) and/or Breast Cancer Foundation (“BCF”) to collect, use, disclose and/or process my personal data in order to process, administer, facilitate, maintain and/or manage my relationship with SCS and BCF as a member, volunteer, programme participant, beneficiary and/or donor (“Purpose”), including communications on SCS’ and BCF’s activities, programmes and services; donation requests; carrying out research, analysis and development activities for SCS’ and BCF’s purposes; and making disclosures required by law or a competent authority. SCS and BCF may, for the above Purpose, disclose my personal data to its third party service providers and/or agents, who may be sited outside of Singapore (subject always to requirements under applicable law having been met).

Mode of Communication
If you wish to receive communications on SCS’ and BCF’s activities, programmes and services via phone call and/or text message to a phone number or numbers that you have provided to SCS and BCF, please TICK the relevant box(es):

On top of email and postal, I would like to be in contacted with organisation via *
Text Message
Phone Call
Email
Singapore Cancer Society
Breast Cancer Foundation
In any event, you agree that SCS and/or BCF may send communications on the follow-up to the screening contemplated in this form, its activities, programmes and services; including (but not limiting to) reminders for rescreen appointment, invitations to cancer awareness public forum, follow-up general cancer management communication to you.

If you do not wish to receive such communications as aforesaid, or if you wish to make changes to consent previously given, you understand that you may write to:

1) “SCS Data Protection Officer” at “Singapore Cancer Society, 15 Enggor Street, #04-01, Realty Centre, Singapore 079716” or to the following email address dataprotection@singaporecancersociety.org.sg.

2) “BCF Finance & Administration” at Breast Cancer Foundation, 5 Stadium Walk, Kallang Leisure Park, #04-03/08 Singapore 397693’’ or to the following email address enquiries@bcf.org.sg.

If you opt out of communications or make changes to consent previously given, please understand that it may affect SCS’ and BCF’s ability to provide services to you.

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