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Get the free Ontario Lung Screening Program Referral Form

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This form is used to refer patients to the Ontario Lung Screening Program (OLSP) for lung cancer screening. It includes sections for patient information, referral criteria, medical history, and provider information.
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How to fill out ontario lung screening program

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How to fill out ontario lung screening program

01
Visit the Ontario Lung Screening Program website or contact a participating hospital.
02
Check your eligibility based on the program criteria.
03
Schedule an appointment with a healthcare provider for an initial assessment.
04
Complete a health questionnaire and discuss your medical history with the provider.
05
Undergo necessary tests, including a low-dose CT scan of the lungs.
06
Receive results and discuss further steps with your healthcare provider.

Who needs ontario lung screening program?

01
Individuals aged 55 to 74 who are current or former smokers.
02
Individuals who have a history of smoking with a significant number of pack years (usually 30 or more).
03
Individuals who have no current signs or symptoms of lung cancer.
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The Ontario Lung Screening Program is a health initiative aimed at identifying lung cancer in high-risk individuals through regular screening methods, including low-dose computed tomography (CT) scans.
Individuals at high risk for lung cancer, typically those aged 55 to 74 who have a history of heavy smoking or are current smokers, are encouraged to participate in the Ontario Lung Screening Program.
To participate in the Ontario Lung Screening Program, eligible individuals must complete a screening questionnaire and obtain a referral from their healthcare provider, which can then be submitted to a designated screening center.
The purpose of the Ontario Lung Screening Program is to detect lung cancer at an early stage when treatment is more likely to be successful, thereby reducing mortality rates from the disease.
Participants in the Ontario Lung Screening Program must report their medical history, smoking status, demographic information, and any previous cancer diagnoses to ensure appropriate screening and follow-up care.
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