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Ann B. Barshinger Cancer Institute

Lung Cancer


Check your lungs

Lung > Physician Referral Form

Physician Referral

Please print out the physician referral information and fax the completed form to 717-544-3098.

There is no need for the office to schedule or pre-authorize the exam.  A CT staff member will contact the patient with appointment details.

Once a referral has been made, a CT Lung Screening Coordinator will:

  • Perform a phone interview
  • Obtain a radiologist order along with insurance pre-authorization
  • Schedule the LCDT

LG health will follow the patient through the screening process, shared decision making, smoking cessation (if applicable), communication of results and follow-ups according to the American College of Radiology Guidelines.  The LCDT results and recommendations will be forwarded to the referring physician as well.  If you have any questions, please do not hesitate to call Computerized Tomography at 717-544-3985 or the Lung Screening Coordination at 717-544-3273

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