Lung Cancer Screening Eligibility Quiz

Lung Cancer Screening Eligibility
Complete this quick form to determine if you are eligible for a low-dose lung cancer screening.

Eligibility

EligibleNot Eligible
Are you between the ages of 50 and 80?*

YesNo
Do you currently smoke, or have you smoked cigarettes in the last 15 years?*

YesNo

Calculate your Cigarette Pack Years
A cigarette pack year is an estimation of the amount of cigarettes you smoked in a year. It is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked. So, if you smoke two packs a day for 10 years, your pack years equals 20. Let's calculate yours.
Years you smoked*
YEARS
Packs of cigarettes smoked per day*
PACKS PER DAY
Pack Year Calculation
Contact Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Should be Empty:

Lung Cancer Screening Eligibility