Guide for Physicians Referring to the Bhalwani Familial Cancer Clinic​

Standard Referral

To complete the standard referral process:

Download and complete the Bhalwani Familial Cancer Clinic Consult Request form.
Fax the completed form to 416 946 6528. The form will be reviewed to ensure that it is complete; if incomplete, the form will be returned to you.
Our office will contact the patient directly with their appointment information.

It is extremely important to ensure that your patient returns their completed family history questionnaire and personal medical history questionnaire to the clinic before their appointment or their appointment may be rescheduled.

If your patient needs an ​ urgent appointment:

  • ​Complete the steps above, including the urgent referral section of the consult request form.

Referral Forms

Checklist for a Complete Referral

To ensure your referral is complete, make sure to include:

  • A referral form filled out in its entirety
  • Information regarding the relevant family history
  • Genetic testing results if available

If this information is not included with the referral form, your referral may be returned as incomplete. ​

Go to the Bhalwani Familial Cancer Clinic​​

Last reviewed: 10/19/2022
Last modified: 11/2/2023 9:17 AM
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