Sign-up for our annual FREE Skin Cancer Screening
Mary Hendrickson-Johnson, American Cancer Society, Regional Cancer Collaborative annual skin screening. Each site has its own Date and Times, please refer to the list below for the specific locations and dates.

Pre-Registration Form

*Please note that all fields are required.
First Name
 Last Name
   Birthdate
 
Address
 City
 State
 Zip
 
Day Time Phone
 E-Mail Address
 Sex:
       
 
  Location (select one)

Requested arrival time (select one) - please allow 60 minutes for complete screening. Your appointment time will be confirmed with you.


If you have any other questions, please call us at (920)433-8488

       


You can bypass the Education Session at the skin screening by completing the online Risk Assessment and Education modules. Follow this link to complete http://www.maryhendricksonjohnson.org/. If you do not wish to complete this online in advance, you will be able to complete this in person at the event.