Are You at Risk?

Are You at Risk?

Registration closes on 15 Nov 2025
This screening campaign is ONLY eligible for participants who are:
- Aged 50 - 80 years old (based on birth date), smoke 20 pack years history or more, and are continuing to smoke or quit less than 15 years ago
  
  OR
  
  Aged 50 - 75 years old (based on birth date) with first-degree family history of lung cancer for non-smokers (parent or child, excluding siblings)
- Possess a valid blue/orange CHAS card or Public Assistance/Special Grant card
Disclaimer:   
Please note that if you are deemed unsuitable for screening by the doctor due to false or inaccurate medical declarations, the consultation fee will be fully borne by you. 
NRIC Name*

Given NameFamily/SurName
Email*
example@example.com
I understand that this screening is only available to individuals who meet specific eligibility criteria, which may include factors such as age, medical history, and other relevant considerations. I acknowledge that a clinician will review my information and may decline my registration if I do not meet the required criteria.*

Yes

How many years ago did you quit smoking?*
How many years have you smoked?*
On average, how many cigarettes did you smoke per day? There are 20 cigarettes in a pack.

Choice of clinic for my consultation appointment*
Choice of clinic for my screening appointment*
Gender*

MaleFemale
Date of Birth*

DayMonthYear
Date
NRIC (last 4 alphanumerical)*
last 3 digits + alpha
Contact Number*
CHAS/Public Assistance Card*

Kindly provide a screenshot of your CHAS card, as downloaded from the Singpass app. Photos of the physical card will not be accepted.
Cancelof

I declare that I have carefully considered the statements made above and they are, to the best of my knowledge, true and correct.*

Yes
I understand that my participation in the 'Are You at Risk' involves sharing my screening results with 365CPS to monitor the overall success of the campaign and to provide me with relevant health information and resources based on my results (if applicable).*

Yes