Request an Appointment We request that you bring your mammogram films if they were not done at one of our Avestēe practices. Name* Date of Birth Phone Number E-Mail Address* Insurance* Choose InsuranceAetnaAncira Enterprises / 90 Degree BenefitsAlliedAmbetterBlue Cross Blue ShieldCoventry / First HealthGEHAGilsbarHealthSmart Preferred Care, Inc.Health Texas Medical GroupHumana (All Products)Humana Military (All Product)Maxor / Ancira EnterprisesMedicareMCCI (Humana Gold)MultiPlanPrivate Healthcare Systems (PHCS)TRICARE (Standard and Select ONLY)United HealthcareWellmedOther If other insurance, please specify Do you have orders from your Doctor?* Please selectYesNo Give us 2 dates you are available First Choice* Second Choice* Weekday Appointment Options Please selectMorning (8:00 am – Noon)Afternoon (Noon-5:00 pm) I need a specific time of Saturday Appointment Options Please selectMorning (8:00 am – Noon) I need a specific time of Please select a Screening Mammography Location* Please selectAlamo Heights, 303 W. Sunset Rd, Suite 200, San Antonio, TX 78209Boerne, 112 Herff Rd, Suite 350, Boerne, TX 78006Stone Oak, 19016 Stone Oak Pkwy, Suite 280, San Antonio, TX 78258Westover Hills, 9842 Westover Hills Blvd., San Antonio, TX 78251 Do you have breast implants?* Please selectYesNo The information enclosed with this transmission are the private, confidential property of the sender, and the material is privileged communication intended solely for the individual indicated. Please leave this field empty.