Lung Cancer Screening Assessment


Disclaimer: This assessment is intended to be a guide only. Results should not replace the medical advice from your physician. If you have any questions about your risk of lung cancer, please consult your physician. If you are eligible for the Lung CT screening, you may receive a follow-up call from our team to assist you in scheduling the screening.


Screening information

Screenings are by physician referral only. Our program follows eligibility guidelines from the National Lung Screening Trial:

  • Adults 55 to 77 years of age
  • Current or former smokers (quit within last 15 years)
  • No symptoms or history of lung cancer
  • 30-pack-year history of smoking
A pack year is the number of packs of cigarettes smoked daily, multiplied by the number of years smoking, such as a pack a day for 30 years, or 2 packs a day for 15.
Assessment form
Step 1: Basic information about yourself



Step 2: Current physician status

If you do not currently have a physician, please leave the following two fields empty.




Step 3: Smoking/Tobacco history

Do you have a history of smoking or using tobacco?





Step 4: Finish!