Welcome Screening for Life service providers. This section will provide up-to-date information, screening guidelines, policy memos, newsletters, and forms. Visit this site regularly to look for new information and updates.

SFL Policy Manual

• PDF Version of the Screening for Life Policy Manual, revised November 2015 – THIS MANUAL IS CURRENTLY BEING UPDATED. PLEASE CONTACT THE SFL PROGRAM IF YOU HAVE QUESTIONS. DHSS_DPH_Healthaccessde@delaware.gov or call 302-744-1040

Provider Newsletters

• December 2024 issue [PDF]
• February 2023 issue [PDF]
• September 2020 issue [PDF] 
• First Quarter 2017 issue  [PDF]
• March 2016 issue  [PDF]
• December 2015 issue  [PDF]
• September 2015 issue  [PDF]
• June 2015 issue  [PDF]
• January 2015 issue  [PDF]
• September 2014 issue   [PDF]
• May 2014 issue  [PDF]
• October 2013 issue  [PDF]
• March 2013 issue  [PDF]
• December 2012 issue  [PDF]
• July 2011 issue   [PDF]
• April 2011 issue   [PDF]
• January 2011 issue   [PDF]
• September 2010 issue   [PDF]
• June 2010 issue   [PDF]
• March 2010 issue   [PDF]

Provider Forms and Applications

•  Instructions for Completing Provider Enrollment Forms   [PDF]  Revised January 2019
•  SFL New Provider Application Form [PDF]  Revised March 2024
•  SFL Provider Enrollment Agreement [PDF]  Revised March 2024
•  SFL Provider Enrollment Agreement for Lung Cancer Screening Providers
•  2025 Screening For Life Allowable CPT Codes and Rates  [PDF]  Updated January 2025
•  SFL List of Providers  [PDF]

Client Enrollment Forms

Send completed enrollment form to:
Screening for Life
540 S. DuPont Highway, Ste. 11
Dover, DE 19901
or email the form to the Screening for Life program.

Screening for Life/Health Care Connection

 

• Client Enrollment Form

  • English [ PDF ]
  • Spanish [ PDF ]
  • Haitian (Creole) [ PDF ]

• Applicant Self-Attestation Form​

  • English [ PDF ]
  • Spanish [ PDF ]
  • Haitian (Creole) [ PDF ]

• Delaware Residency Verification Form

  • English [ PDF ]
  • Spanish [ PDF ]
  • Haitian (Creole) [ PDF ]

• Employment Verification Form ( Applicant )

  • English [ PDF ]
  • Spanish [ PDF ]
  • Haitian (Creole) [ PDF ]

• Employment Verification Form ( Spouse / Parent Guardian )

  • English [ PDF ]
  • Spanish [ PDF ]
  • Haitian (Creole) [ PDF ]

• Financial Support Verification Form

  • English [ PDF ]
  • Spanish [ PDF ]
  • Haitian (Creole) [ PDF ]

• Eligibility and Acceptable Information

  • English [ PDF ]
  • Spanish [ PDF ]
  • Haitian (Creole) [ PDF ]

• Information Sheet ( What is SFL / HCC? ) 

  • English [ PDF ]
  • Spanish [ PDF ]
  • Haitian (Creole) [ PDF ]

Please Note:  These forms require legal size (8.5″ x 11″) paper.

Return to Screening for Life home page.

 

Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader. A free copy of Adobe Acrobat Reader can be downloaded directly from Adobe . If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe’s Accessibility Tools page.