Lung Cancer Screening Request

If you are between the ages of 55 and 77 years old, and if you are a current or former tobacco smoker, you may be eligible to participate in a screening program. The Lung Cancer Screening program was developed to assist patients in the early detection of lung cancer and the good news is most insurance companies do not charge copay or deductible for the screening. Please complete the following questions and someone from the Lung Cancer Screening team will contact you within 24-48 business hours.

* Asterisk indicates required field.

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Criteria
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Note that if you quit smoking more than 15 years ago you may not qualify for the screening.
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Location Preference
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If this is an emergency, call 911 or go to your nearest emergency department.

For your safety, please select a MyChart video visit on demand or call our MyCare Advice Line at 844-262-1949 before scheduling if:

  • You currently have a temperature greater than 100.4 degrees Fahrenheit
  • In the past 21 days, you have been diagnosed with COVID-19
  • In the past 14 days, you have had contact with anyone diagnosed with COVID-19
  • You are experiencing a new loss of taste and/or sense of smell
  • If you have experienced two or more of the following symptoms in the last 3 days:
    • fever
    • chills
    • drenching sweats
    • new cough
    • shortness of breath
    • body aches
    • headache
    • sore throat
    • runny nose or nasal congestion
    • nausea/vomiting/diarrhea

Henry Ford Health System is committed to ensuring our Deaf or hard-of-hearing patients and visitors have equal access to all services. We provide the appropriate auxiliary aids and services, including qualified sign language interpreters, TTYs and other assistive listening devices, at no cost. To request assistance, call 313-916-1896 or email CommunicationAccess@hfhs.org.

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