Sept.

1, 2017

IMPORTANT INFORMATION ABOUT YOUR

MAMMOGRAM (BREAST X-RAY EXAM)

CERTIFIED MAIL

Thank you for choosing JPS Health Network as your partner in improving your health. We are
honored to be your health care provider.

Although you may have already been contacted by JPS, we are writing to let you know about a
potential concern with the image quality of the mammogram we performed for you at JPS Medical
Home Southeast Tarrant, located at 1050 W. Arkansas Lane, Arlington, TX 76013 (Arlington Facility).
We have also sent a letter to your health care provider about this issue.

JPS strongly believes in providing the highest quality care. Likewise, the Texas Department of
State Health Services (DSHS) ensures mammography facilities meet certain quality standards. A
sample of mammograms taken at the Arlington Facility on behalf of DSHS between May 2, 2015 and
May 2, 2017 was recently reviewed. During this review, some mammograms in the sample were
determined not to meet certain image quality standards as defined by federal and state regulatory
agencies.

JPS always wants to put quality patient care first. Therefore, we are checking back with you out
of an abundance of caution. If you have not had a mammogram taken since the one you had taken
between the May 2, 2015 and May 2, 2017, we recommend you talk with your physician to decide
whether you should schedule another exam.

HERE ARE OUR RECOMMENDATIONS:

If you have had a mammogram at another facility since the one taken at the Arlington Facility
between May 2, 2015 and May 2, 2017, you do not need to do anything other than follow your
physicians recommendations from that subsequent mammogram.

(please continue to other side)

 If you have not had a mammogram taken since the one you had taken at the Arlington Facility
between May 2, 2015 and May 2, 2017:

- We recommend you talk with your physician about your medical follow up. We have sent a
letter to the physician who referred you to us for your mammogram explaining this concern.
Your physician may consider ordering a repeat mammogram.

- If your physician wants you to have your mammogram repeated, it should be done at a MQSA-
certified facility. JPS Health Network will be happy to schedule you at our other MQSA-certified
facilities. Additionally, the following facilities are conveniently located near the Arlington
Facility where you last had your mammogram:

1. Arlington Medical Imaging, 3025 Matlock Road, Suite 100, Arlington, TX 76015
2. Solis Mammography at Medical Center of Arlington, 515 W. Mayfield Drive, Suite 100,
Arlington, TX 76014
3. Touchstone Medical Imaging Arlington, 601 W. Arbrook Blvd., Arlington, TX 76014

- If you are JPS Connection eligible, your subsequent mammogram will be paid under your
Connection membership.

The accuracy of our tests and the quality of the care we provide our patients are of the highest
importance to JPS. If you have any questions or concerns, you may contact the Mammography
Department at JPS Medical Home Southeast Tarrant at 817-702-4498.