Current Provider Information

• All Take Charge Contracted Facilities
• Contractor Invoice Schedule - FY 2025

• Breast Imaging
• Breast Surgical Consult
• Cervical Dysplasia Services
• Fee for Services
• Laboratory Services

• Breast Cancer Screening Orders & Guidelines
• Cervical Cytology Guidelines and Orders
• Dysplasia Guidelines and Orders

• Diagnostic Breast Imaging Services
  
• Breast Surgical Consultation Services
• MRI Services
• Dysplasia and Cervical Consult Services

• ODH Form 1342 - Screening and Diagnostic Services Form and Instructions
• 1341 Form - Take Charge Eligibility Form

(This is for new providers after contract approval or for renewals of current providers.)

• Health Care Provider Licenses and Documentation form

(Request media materials such as brochures, postcards or business cards with Take Charge information to share with your community and clients.)

• Materials Order form

Physical Address:
Oklahoma State Department of Health
Chronic Disease Prevention Service
123 Robert S. Kerr Ave.
Oklahoma City, OK 73102

Phone: (405) 426-8290; Toll-Free (888) 669-5934
Fax: (405) 900-7609
Email: CancerPCP@health.ok.gov