Lung, Head and Neck Tumor Board

The Lung, Head & Neck tumor board meets every Monday at 7 a.m. (60 min) - CME offered

Meeting Type: Virtual Only
Virtual Link: Zoom meeting invite sent via email

Tumor Board Registration

Presenter Details

Presenter Name

Phone Number

Submitter Name

Submitter Email Address (Fill out for email confirmation)

Conference

Conference Date

For this conference, you can only select Monday's from the calendar.

Patient Information

Patient First Name

Patient Middle Name

Patient Last Name

Patient Name Suffix

Patient Diagnosis

Patient Date of Birth

Medical Record Number (MRN)

Clinical Stage

Clinical Questions to be addressed

Radiology Studies - list only what is needed to be reviewed and presented at conference

Radiology Studies

PLEASE CLEARLY INDICATE the Facility Names (even if at HonorHealth, SMIL), Type of Exams/Imagings & Exam Dates of what you need. BE SPECIFIC as it will only help expedite the process. If not needed, type "NA". CORRECTLY SELECT "radiology imaging"; "radiology report review only" or "radiology not needed". HOW & WHAT YOU SUBMIT for radiology is what WILL ONLY be processed!

Radiology Study Options

Ask a Radiologist

What specifically do you want reviewed or questions you need answered to help direct the focus of our assigned radiologist.

Pathology Studies - List only what is needed to be reviewed and presented at conference

Pathology Studies

PLEASE CLEARLY INDICATE the Facility Names (even if at HonorHealth, Shea Anatomic or Western & Pinnacle ), Type of Exams/Slides & Exam Dates of what you need. BE SPECIFIC as it will only help expedite the process. If not needed, type "NA". CORRECTLY SELECT "pathology slide image"; "pathology report review only" or "pathology not needed". HOW & WHAT YOU SUBMIT for pathology is what WILL ONLY be processed!

Pathology Study Options

Ask a Pathologist

What specifically do you want reviewed or questions you need answered to help direct the focus of our assigned pathologist.

Genetic Testing

Germline Genetic Testing

If yes, please describe the result:

Somatic Genetic Testing

Clinical Team

Surgeon

Medical Onc

Radiation Onc

Primary Care Provider

Clinical Team - Other

Clinic Locations

Special Request for Attendance

List name/contact info of whom you request to be present for this case presentation

Case Summary

Case Summary & Discussion Question(s)