Low-Dose CT Lung Cancer Screening

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Are You a Candidate?

Lung Cancer Screening Questionnaire

Are You Eligible for a Lung Cancer Screening Exam? Fill out this quick questionnaire to find out!

Are you between the ages of 50 and 80?
Do you currently smoke cigarettes or have you quit within the past 15 years?
Did you smoke heavily for at least 20 years?
If so, how many cigarettes did you smoke per day?
Do you have any symptoms such as unexplained weight loss or coughing up blood?

(Note: lung cancer screening is for people without symptoms. If you are experiencing symptoms, please speak with your doctor right away.)

If you answered "Yes" to questions 1, 2, and 3 and "No" to question 4, you may qualify!

 
 
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