Request a Lung Screening Appointment

Lung cancer causes more deaths than the next three leading types of cancer combined. But when caught early, it’s highly treatable. A simple CT scan has been proven to save lives.

Patient Information

Full Name Maiden Name Gender Male Female Date of Birth Marital Status Last 4 Digits of Social Security Number

Contact Information

Contact Name (if different) Relationship Street Address City State/Province Postal Code Phone Email Preferred Callback Time

Medical Information

Exam/Procedure Diagnosis Ordering Physician's Name Primary Physician's Name Insurance Company Insurance Authorization/Referral Number

Appointment Preference

Preferred Location(s) Memorial Regional Hospital Memorial Hospital Miramar Memorial Hospital West Preferred Day(s) Wednesday Thursday Friday Saturday (limited testing) Sunday (limited testing) Preferred Time(s) Early Morning (6AM - 9AM Morning (9AM - 12AM) Early Afternoon (12PM - 3PM) Afternoon (3PM - 6PM) Evening (6PM - 9PM)

A doctor's prescription is required for all tests and procedures.

Some insurance companies require an authorization for scheduled procedures.

Contact Us

Make an appointment today to get a lung screening.

954-276-5500

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84.7% of Memorial Cancer Institute adult patients answered "always" when asked if they had access to the care that they required.

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Memorial has been named to Florida Trend magazine's 2015 list of "Florida's Best Companies to Work For." It's the 7th consecutive year that we have ranked on Florida's Trend's list.

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Request a Lung Screening Appointment

It matters to you. It matters to us.

Memorial Cancer Institute Patient Satisfaction Scores

Memorial Named One of "Florida's Best Companies to Work For"

You Have a Right to Know About Prices