Cancer Care Physician Referral Forms

Breast Cancer Care

Care is provided through an Integrated Care Collaborative (ICC), a system of health care providers, clinics and services focused on breast cancer patients and their families. This focus means patients receive evidence-based care, following best practices in a multidisciplinary, collaborative environment.

  1. Breast Cancer Care PDF Referral Form (Please note the online referral form is no longer available, please use the PDF referral form)  
  2. Referral Form for Breast Cancer Navigation
  3. Referral Form for Breast Cancer Lymphedema Care

Description of Breast Cancer Care 
 

Colorectal Cancer Care

FIT Positive Colonoscopy Referral Form 

 

Colorectal Diagnostic Assessment Program

Colorectal Diagnostic Assessment Program Online Referral Form
Colorectal Diagnostic Assessment Program PDF Referral Form Download: Colorectal Diagnostic Assessment Program referral form
 

Endoscopy

Expedited Colonoscopy Referral Form
The Expedited ColonoscopyProgram ensures patients with concerning symptoms are booked for a colonoscopy in a timely fashion. It is for patients with: 1. positive fecal occult blood in stool; 2. anemia; 3. family history of colorectal cancer; 4. concerning change in bowel habit or new onset of rectal bleeding; 5. palpable rectal mass. The expedited colonoscopy program is not for patients requiring routine screening.
Description of our Endoscopy Clinic
 

Palliative care

Freeman Centre for the Advancement of Palliative Care, In-home Care Referral 
See the Palliative Care Program referral forms 


Prostate cancer care

Gale and Graham Wright Prostate Centre
The Gale and Graham Wright Prostate Centre at the Branson Ambulatory Care Centre is a unique facility offering patients dramatically reduced wait times for assessment, diagnosis, counseling and treatment.
North York General Prostate Centre Referral Form

Description of the prostate centre.
 

Hematology/Oncology

Hematology/Oncology Centralized Referral Program 
This central intake referral program expedites access for patients who require a consult with a haematologist or oncologist. Referrals are booked according to the next available physician (unless otherwise indicated) ensuring patients are seen within 2 weeks. Improving access to oncological and hematological services has significant benefit to patients for early diagnosis and possible earlier intervention.
Hematology and Oncology Referral Form


Pain and Symptom Management Clinic 

This clinic is a team of health care providers working with North York General oncologists, surgeons and palliative care physicians to manage complex pain and symptom issues related to their patients' care.

Pain and Symptom Management Clinic Referral Form
Description of the Pain and Symptom Management Clinic