Among mammography patients, a small but growing group of highly motivated women refer themselves directly for screening without the suggestion of their physicians. We surveyed 485 patients during a 3-month period to study how self-referred mammography patients differ from physician-referred patients. Self-referred patients were more likely than physician-referred patients to have a family income of more than $30,000 per year, to be college graduates, and to consider their health as good or excellent. A large percentage of self-referred patients performed other health-promoting practices, but were not significantly more likely to do these than were physician-referred patients. Women who referred themselves were more likely to have a friend with breast cancer and to believe that cancer could be cured. They expressed much less worry about radiation exposure and were more likely to consider $50.00 an appropriate charge for a screening mammogram. By far, the greatest motivator for self-referred patients was health promotion and disease prevention. Self-referred mammography patients tend to be wealthier, more education, and less concerned about the cost and radiation dose of mammography when compared with physician-referred mammography patients.