We’re grateful for each referral you make to WCSC, whether it be for a patient requiring an initial cancer assessment, screening or surveillance, treatment, or a second opinion.  We will keep you informed throughout the referral process and your patient’s course of treatment.

We thank you for your partnership.

Required Referral Information

Patient Information                            

  • Name
  • Address
  • Date of birth
  • Telephone number
  • Diagnosis
  • Date of diagnosis
  • How the diagnosis was made (physical exam, biopsy, other)
  • What treatment the patient has undergone to date
  • When this treatment was administered and completed
  • Current condition
  • Insurance information

Referring Physician Information

  • Name
  • Office address
  • Telephone number
  • Fax number
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