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