Contact Form – Kentucky LEADS

Tell us how we can help you:

Mail me a free copy of Lung Cancer in Kentucky: A Primary Care Action Plan.
Call my office to schedule a brief academic detailing visit (eligible for CME/CE credit) to share tools I can use in my primary care practice. (Free copy of Lung Cancer in Kentucky included.)
Other:

Name:

Practice address:

Practice city:

Zip:

Provider type:

Email:

Office phone:

Staff person who will schedule visit:

Other comments:

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