Skip to Main Content

Patient Intake Form – PSMA (Pluvicto)

Patient Intake Form – PSMA (Pluvicto)

Thank you for your interest in our PSMA (Pluvicto) treatment for advanced prostate cancer. We want to help you find out if Pluvicto is the right treatment for you. Please complete our patient intake form so we can learn more about your healthcare journey.

To receive the PSMA (Pluvicto) treatment under current guidelines, patients will need to have been treated with androgen receptor (AR) pathway inhibition, along with at least one taxane-based chemotherapy treatment.

We encourage all prostate cancer patients to complete this form as we have alternative treatments available, and the clinical guidelines for PSMA may change as further research emerges. We would like to remain in communication to keep you updated.

Scheduling Notice

ARA is experiencing record call volumes. We are aggressively working to remedy this situation. PLEASE NOTE THAT SCREENING MAMMOGRAMS AND ULTRASOUNDS CAN BE SCHEDULED ONLINE. If you schedule a callback and your call is not received during the predicted time frame, please note you are still in the queue and we will call you back as soon as an agent is assigned to your call. We apologize for the extra wait time you may experience and appreciate your patience. For routine X-ray, scheduling is not required--you can walk into any ARA location that does X-ray.

Close Icon
Back to Top
Technical Assistance