ATTENTION: If you think you are experiencing COVID-19 symptoms, call our COVID-19 triage line at 503-814-0099 before entering a Salem Health Hospitals and Clinics facility. This includes staff. Anyone at a Salem Health facility (inside or outside) must wear a facial mask at all times.
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Forms and downloads

Can’t find a form you received from your doctor? These electronic versions are provided for your convenience. If you need a form that is not available here, call us at 503-562-4321 or stop by the lobby information desk. We’ll be happy to find you what you need.

LDCT information packet

Lung Cancer Screening Program FAQ 11-28-16
LDCT Guidelines for Providers 11-28-16
Lung Cancer Screening Eligibility Quick Reference Guide for Providers 11-28-16
Low Dose CT Eligibility Referral Form 12-07- 2016
Lung Cancer Screening Shared Decision Making Checklist 11-28-16

Other forms

Cancer registry—This form authorizes us to collect follow-up data after your treatment is complete.