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Referring Patients to the Stronach Regional Cancer Centre at Southlake
Referrals
The Regional Cancer Program at Southlake is designed to ensure that patients receive a consistently high quality of cancer care, in a timely fashion, and as close to home as possible. It is the designated Regional Cancer Centre for the Central Regional Cancer Program, one of 14 Regional Cancer Programs in Ontario.
 
We have made it our commitment to ensure prompt management of patients and timely response to referring physicians and health care professionals.

Referrals can be made by completing a Referral Form and faxing it to 905-952-2820. For information on what to include with your referral, please see Referral Information below.

Any questions regarding referrals can be directed to:

Medical Oncology 905-895-4521, ext. 2624
Radiation Oncology 905-895-4521, ext. 2804
 
Referral Information
In order to provide the best possible care to patients you are referring, please endeavor to provide the following information:

Referral Form

Outpatient Psychosocial Oncology & Palliative Care Referral Form

The following information must be included with all referrals:

 

Referring Physician contact information

  • Name
  • Address
  • Phone Number
  • Fax Number
  • Email

Patient Medical History

  • Medical History
  • Surgeries/Procedures
  • Devices: type/settings

Patient Information

  • Name
  • Date of Birth
  • Address
  • Phone Number
  • Email
  • OHIP #
Patient's current Medications
  • Type(s)
  • Dosages
  • Allergies
  • Diagnostic Test reports
Information for your patients

To ensure the best possible care, please ensure your patients bring the following items to their first appointment:

  • Ontario Health Card
  • All medicines they are currently taking, including all over-the-counter drugs, vitamins, minerals, and herbal supplements, in their original containers
  • Name, address and phone number of the family doctor
  • Name, address and phone number of their drug store
  • Group and policy numbers for their drug insurance plan
  • Eyeglasses or hearing aid if used
  • If they are diabetic, ensure they bring meals, insulin and related supplies
  • A family member or someone to take notes during the visit

 

Southlake Regional Health Centre
596 Davis Drive, Newmarket, Ontario   L3Y 2P9
Tel: 905-895-4521   |   TTY: 905-952-3062
Copyright © 2012 Southlake Regional Health Centre
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