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Stay CLEAR of Gastric Cancer
Registration closes 31 October 2026
This screening campaign is ONLY eligible for participants who are:
Individuals aged 40 and above (based on birth date)
Possess a valid blue/orange CHAS card or Public Assistance/Special Grant card
I understand that this screening is only eligible for individuals who meet the specified criteria, which may include age, medical history, and other relevant factors. I also understand that the clinician has the right to reject my registration should I fail to meet the eligibility criteria.
*
Yes
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Full Name in NRIC
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Given Name
Family/SurName
Date of Birth
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Gender
*
Male
Female
NRIC (last 4 alphanumerics)
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last 3 digits + alpha
Email
*
example@example.com
Contact Number
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I have a
CHAS Blue Card
CHAS Orange Card
Public Assistance Card (Green CHAS Card is not acceptable)
CHAS/Public Assistance Card
*
Browse Files
Drag and drop files here
Choose a file
Please upload a photo/screenshot image of your Blue or Orange CHAS card or Public Assistance card (front) for verification.
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This is my first Gastric Cancer screening
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Yes
No
My last Gastric Cancer screening was in
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Date
Choice of clinic for my screening appointment
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Please Select
HMI Medical Centre (Farrer Park Station Road)
SATA CommHealth (Ang Mo Kio)
SATA CommHealth (Bedok Uttamram)
SATA CommHealth (Geylang East)
SATA CommHealth (Jurong)
SATA CommHealth (Tampines)
SATA CommHealth (Woodlands)
I declare that I have carefully considered the statements made above and they are, to the best of my knowledge, true and correct.
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Yes
I understand that my participation in the 'Stay CLEAR of Gastric Cancer' 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
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This is the first time I'm learning about 365CPS.
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Yes
No
This is my first time participating in a screening offered by 365CPS
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Yes
No
I learn about this screening through
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365CPS Website
365CPS Staff/Social Service Centre
Email
Facebook
Instagram
TikTok
LinkedIn
Events/Roadshows
TV
Radio
Newspaper
Word of Mouth (Family/Friends/Colleagues)
Ain Society
Singapore Women's Association
Tzu-Chi Foundation (Singapore)
Bukit Panjang Constituency
Eunos Constituency
Tampines Constituency
Fei Yue Community Services
I would like to be notified on 365CPS upcoming activities and screening programmes.
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Yes
No
Additional Medical History
By participating in this screening, you acknowledge and expressly consent to the collection, use, and disclosure of your personal data, including medical information, by 365CPS and its authorised partners. This information will be used solely for administering the screening, providing resources, guidance, follow‑up support, and complying with regulatory requirements. Your data may be shared with laboratories, partner healthcare institutions, and relevant government agencies where necessary. Providing personal data is voluntary; however, failure to do so may prevent us from processing your screening application or related services. All personal data will be kept confidential and managed in accordance with the Personal Data Protection Act (PDPA) and applicable healthcare regulations.
Disclaimer:
This screening is conducted for preventive purposes and early detection only. It is not intended to replace any full medical evaluation, diagnosis or treatment by a qualified healthcare professional. 365 Cancer Prevention Society (365CPS) and its partners shall not be held liable for any accidents, injuries, medical complications, or delays in diagnosis or treatment that may occur before, during, or after the screening. Participants are responsible for providing accurate medical information, and incomplete or false declarations may affect the validity of results or incur additional costs or follow up treatment. By participating in the screening, you acknowledge that it is conducted on a voluntary basis and agree to assume full responsibility for your own health and safety.
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