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PEEL REGIONAL CANCER PROGRAM HEPATOPANCREATICBILIARY (HUB) SURGICAL ONCOLOGY REFERRAL FORM Telephone 18665304464 Fax 18775304425 Dr. Philippe Garçon Dr. Joseph Wen Referring Physician: Family Physician
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How to fill out peel regional cancer program

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How to fill out the Peel Regional Cancer Program:

01
Gather necessary information: Before starting the application, make sure to collect all the required information such as personal details, medical history, and contact information.
02
Access the application form: Visit the official website of the Peel Regional Cancer Program or contact them to obtain the application form. The form may be available online or in physical copy.
03
Read the instructions carefully: Take the time to read through the instructions provided with the application form. This will help you understand what information is required and how to complete each section accurately.
04
Provide personal details: Begin filling out the form by providing your personal details, including your full name, date of birth, address, and contact information. Double-check for any errors before proceeding.
05
Medical history: In this section, provide your medical history related to cancer, including any diagnoses, treatments, surgeries, or medications you have had in the past. Be thorough and include any relevant details that may assist the program in evaluating your case.
06
Provide supporting documents: Some programs may require additional documentation to support your application. This may include medical reports, test results, referral letters, or any other pertinent documents. Make sure to attach these documents to your application securely.
07
Contact information for healthcare professionals: If required, provide the contact information for your healthcare professionals, such as your primary care physician, oncologist, or any other specialists you may be seeing.
08
Review and submit: Once you have completed the application form, carefully review all the provided information to ensure accuracy. Check for any missing or incomplete sections. If everything is correct, submit your application as per the instructions provided.

Who needs Peel Regional Cancer Program:

01
Individuals diagnosed with cancer: The Peel Regional Cancer Program is primarily designed to provide specialized care and support to individuals who have been diagnosed with cancer. This may include various types of cancer, such as breast, lung, prostate, or colon cancer, among others.
02
Patients seeking comprehensive cancer treatment: The program is suitable for patients who require comprehensive cancer treatment, including access to oncologists, specialized medical facilities, chemotherapy, radiation therapy, surgery, and other related services.
03
Residents of the Peel Region: The Peel Regional Cancer Program primarily serves the residents of the Peel Region, which includes cities like Brampton, Mississauga, and Caledon in Ontario, Canada. Individuals residing within this region may benefit from the services provided by the program.
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The Peel Regional Cancer Program is a program that provides cancer care services to residents in the Peel region.
Healthcare facilities and organizations providing cancer care services in the Peel region are required to file the Peel Regional Cancer Program.
To fill out the Peel Regional Cancer Program, healthcare facilities and organizations need to report specific information related to cancer care services provided.
The purpose of the Peel Regional Cancer Program is to ensure quality cancer care services are provided to residents in the Peel region.
Information such as number of cancer cases treated, types of treatment provided, outcomes of treatment, and patient demographics must be reported on the Peel Regional Cancer Program.
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