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Lung Center New Patient Appointment Requests

By using this form you may refer yourself to our clinic. Your information will be sent securely via email to one of our New Patient Coordinators. You will be contacted shortly to set up a time for the appointment and to give you additional information. If you prefer, you may call our Patient Coordinators directly at 1-844-BWH-LUNG (1-844-294-5864) Monday through Friday, 7:30am - 5:00pm. 

Please include reason for appointment in the Additional Information field below. For example, Lung Cancer Screening, nodule scan.

A ( * ) indicates a required field.

Please verify that you are not a robot by clicking on REQUEST APPOINTMENT

Thank You for Your Lung Center Appointment or Referral Request

Your Lung Center appointment request has been submitted.