Form preview

Get the free Low-dose CT Lung Cancer Screening Program - accc-cancer

Get Form
Northwest Community Healthcare 800 W. Central Road Arlington Heights, IL 60005 INCH Logo Low does CT Lung Cancer Screening Program Lung cancer screening with low dose CT (LCT) has been shown to save
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign low-dose ct lung cancer

Edit
Edit your low-dose ct lung cancer form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your low-dose ct lung cancer form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing low-dose ct lung cancer online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Follow the guidelines below to benefit from a competent PDF editor:
1
Log into your account. If you don't have a profile yet, click Start Free Trial and sign up for one.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit low-dose ct lung cancer. Add and change text, add new objects, move pages, add watermarks and page numbers, and more. Then click Done when you're done editing and go to the Documents tab to merge or split the file. If you want to lock or unlock the file, click the lock or unlock button.
4
Save your file. Select it from your records list. Then, click the right toolbar and select one of the various exporting options: save in numerous formats, download as PDF, email, or cloud.
With pdfFiller, it's always easy to work with documents. Try it out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out low-dose ct lung cancer

Illustration

How to fill out low-dose CT lung cancer?

01
Gather personal information: Start by filling out the necessary personal information such as name, date of birth, contact details, and social security number.
02
Medical history: Provide a comprehensive medical history, including any previous and current medical conditions, medications, surgeries, allergies, and known risk factors for lung cancer.
03
Symptoms and concerns: Write down any symptoms or concerns you may have related to lung cancer. This can help the healthcare provider understand your specific situation better.
04
Smoking history: Indicate your smoking history, including the number of years smoked, average number of cigarettes smoked per day, and whether you have quit smoking or are currently a smoker.
05
Exposure history: Detail any potential exposure to lung cancer risk factors such as secondhand smoke, asbestos, radon gas, or occupational hazards.
06
Family history: Provide information about any family history of lung cancer or other related conditions. This may include immediate family members (parents, siblings) or extended family members.
07
Other relevant information: Include any additional relevant medical or lifestyle information that may aid in assessing your risk of developing lung cancer.

Who needs low-dose CT lung cancer?

01
Individuals at high risk: Low-dose CT lung cancer screening is recommended for individuals who are at high risk of developing lung cancer. This includes current or former heavy smokers, aged 55-80, who have a smoking history of 30 pack-years or more (one pack-year is equivalent to smoking one pack per day for one year).
02
Previous lung cancer patients: Individuals who have been previously diagnosed with lung cancer and have completed their treatment may be recommended for low-dose CT screening to monitor for potential recurrence or new lung tumors.
03
Occupational exposure: Certain occupations and exposure to substances like asbestos or radon gas can increase the risk of developing lung cancer. Individuals with a history of occupational exposure to lung cancer risk factors may be advised to undergo low-dose CT screening.
04
Family history: Individuals with a first-degree relative (parent, sibling, child) who has been diagnosed with lung cancer may be considered at increased risk and may benefit from low-dose CT screening.
05
Others at risk: In some cases, healthcare providers may recommend low-dose CT lung cancer screening for individuals who exhibit certain risk factors such as a history of chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, or a known exposure to specific carcinogens.
Remember, it's always best to consult with a healthcare professional to determine your individual risk and eligibility for low-dose CT lung cancer screening.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.0
Satisfied
37 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Low-dose CT lung cancer screening is a test used to detect lung cancer at an early stage in individuals who are at high risk for the disease.
Individuals who are at high risk for lung cancer, such as current or former smokers, may be recommended to undergo low-dose CT lung cancer screening by their healthcare provider.
To undergo low-dose CT lung cancer screening, individuals should consult with their healthcare provider to determine if they meet the criteria for screening and to schedule the test.
The purpose of low-dose CT lung cancer screening is to detect lung cancer at an early stage when it is more treatable, potentially saving lives.
The results of the low-dose CT scan and any relevant medical history must be reported on low-dose CT lung cancer screening.
It is possible to significantly enhance your document management and form preparation by combining pdfFiller with Google Docs. This will allow you to generate papers, amend them, and sign them straight from your Google Drive. Use the add-on to convert your low-dose ct lung cancer into a dynamic fillable form that can be managed and signed using any internet-connected device.
It's simple with pdfFiller, a full online document management tool. Access our huge online form collection (over 25M fillable forms are accessible) and find the low-dose ct lung cancer in seconds. Open it immediately and begin modifying it with powerful editing options.
Make sure you get and install the pdfFiller iOS app. Next, open the app and log in or set up an account to use all of the solution's editing tools. If you want to open your low-dose ct lung cancer, you can upload it from your device or cloud storage, or you can type the document's URL into the box on the right. After you fill in all of the required fields in the document and eSign it, if that is required, you can save or share it with other people.
Fill out your low-dose ct lung cancer online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.