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Page 1: Hispanic Women;  All ages;  Wicomico, Somerset or Worcester County residents;  No health insurance or insurance with high deductibles.* *As determined.
Page 2: Hispanic Women;  All ages;  Wicomico, Somerset or Worcester County residents;  No health insurance or insurance with high deductibles.* *As determined.

Hispanic Women; All ages; Wicomico, Somerset or

Worcester County residents;

No health insurance or insurance with high deductibles.*

*As determined by Komen staff.

All services are FREE for women who meet the program criteria.

Page 3: Hispanic Women;  All ages;  Wicomico, Somerset or Worcester County residents;  No health insurance or insurance with high deductibles.* *As determined.

SCREENING SERVICESSCREENING SERVICES Clinical Breast Exam Mammogram Diagnostic

Mammogram Ultrasound Surgical Consultation

SUPPORT SERVICESSUPPORT SERVICES Interpretation and

Translation Services Transportation

Page 4: Hispanic Women;  All ages;  Wicomico, Somerset or Worcester County residents;  No health insurance or insurance with high deductibles.* *As determined.

No documentation is required for the Komen Breast Cancer Screening Program.

If further diagnosis or treatment is required after screening, pay stubs and proof of residency will be required for referral to the State of Maryland Diagnosis and Treatment Program.

Page 5: Hispanic Women;  All ages;  Wicomico, Somerset or Worcester County residents;  No health insurance or insurance with high deductibles.* *As determined.

Contact Zlatica Koscina at the Wicomico Co. Health Dept:(410) 334-3480 x 17484

Please provide:› Patient’s name› Contact phone number› Screening services requested


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