Do I Need a Referral for a Mammogram in Ontario?

The rules for breast screening changed in late 2024. Find out if you can "self-refer" for your mammogram at age 40, and when you still need a doctor’s requisition.

For decades, the rule in Ontario was simple: You need a doctor's note for everything. But when it comes to breast health, those rules have changed to put more power in your hands.

If you are confused about whether you need a referral for a mammogram, you are not alone. The guidelines recently shifted in October 2024, and many patients in Guelph are still unsure if they can just "call and book" or if they need to see their family doctor first.

At Frontier Diagnostics, we want to clear up the confusion. The answer depends entirely on why you are having the scan.

Scenario A: "I feel fine, I just want to be safe." (Screening)

The Verdict: NO Referral Needed (For Ages 40-74)

This is the biggest change in Ontario healthcare.

As of October 8, 2024, the Ontario Breast Screening Program (OBSP) lowered the self-referral age. You can now book your own mammogram without a doctor’s requisition if you meet these criteria:

You are between 40 and 74 years old (previously this started at age 50).
You have no current symptoms (no lumps, nipple discharge, or new pain).
You have no personal history of breast cancer.
You have not had a mammogram in the last 11 months.

If you fit this description, you can bypass your doctor completely and call an OBSP-affiliated clinic directly to book your appointment.

Scenario B: "I found a lump" or "I have pain." (Diagnostic)

The Verdict: YES, You Need a Referral

This is a critical distinction. The "self-referral" program is strictly for screening (looking for cancer in healthy people).

If you are booking because you found a lump, noticed nipple discharge, or are feeling a new, specific pain, you are no longer a "screening" patient. You are a "diagnostic" patient.

Why the difference? A diagnostic mammogram is more complex. The radiologist needs to know exactly where the problem is to take extra views or perform an ultrasound at the same time.
What to do: See your doctor or a walk-in clinic first. They must give you a requisition form marked "Diagnostic Mammogram" or "Breast Ultrasound."

Scenario C: "I am High Risk." (Ages 30-69)

The Verdict: YES, You Need a Referral

If you have a strong family history of breast cancer (e.g., mother or sister diagnosed young) or a known genetic mutation (like BRCA1 or BRCA2), you may qualify for the High Risk OBSP.

This program starts screening much earlier (age 30) and often includes an MRI along with a mammogram.
Because this involves specialized genetic assessment, you cannot self-refer. Your doctor must send a specific referral to the High Risk program for you.

Scenario D: "I am over 74."

The Verdict: YES, You Need a Referral

Once you turn 75, you "age out" of the automatic OBSP recall list. However, that doesn't mean you stop checking! It just means you need to visit your family doctor to get a requisition form every time you want to be screened.

How to Book at Frontier Diagnostics

Whether you are "self-referring" for your first baseline mammogram at 40 or coming in with a requisition from your doctor, our team is here to help.

Frontier Diagnostics uses state-of-the-art digital mammography to ensure your scan is quick, comfortable, and precise.

For Screening (Ages 40-74): Call us directly to see if you qualify for an OBSP self-booking.
For Diagnostic: Have your requisition ready and click here to book.

This blog is for general information only and isn’t intended to be medical advice. Please consult a healthcare provider for any questions or concerns about your own health.