Schedule Your Screening

Ready to prioritize your health? Fill out the form below to request more information or schedule a preventive screening.

Choose the service you're interested in, and we'll connect you with the right team. We'll follow up within 48 hours (or 3 business days) to help guide you through the process, including any referral requirements.

Screening services are available at Memorial Health locations and require a physician referral. If you don’t have a primary care doctor, click here and we’ll connect you with the right one.

Screening Interest

Which screening are you interested in? (If requesting more than one screening, please submit a new request.)

Lung Screening
Heart Screening
Colorectal Cancer Screening
Breast Cancer Screening

What is your preferred community?

Patient Information

First Name

Last Name

Phone Number

Email Address

Preferred method of contact?

Phone
Email

Additional Information

I understand that screenings require evaluation and referral by a primary care provider before scheduling. A Memorial Health representative may contact me regarding my screening request.

I consent to being contacted by phone and/or email regarding my screening request.