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All models who are currently in or are within five years of treatment are required to submit a signed medical release. Please print off the form below and return it to the PBH Office 5 pm June 26, 2020.

Return Completed Forms To:

Panhandle Breast Health

301 S. Polk, Suite 740

Amarillo, Texas 79101

 

PANHANDLE BREAST HEALTH

301 South Polk Street, Suite 740

Amarillo, Texas 79101

806.331.4710

© 2020 | All Rights Reserved  |  Panhandle Breast Health  

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