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PATIENT REFERRAL FORM Outpatient Oncology New Patient Referral Juravinski Cancer Centre 699 Concession Street Hamilton ON L8V 5C2 Please COMPLETE ALL INFORMATION and FAX TO 905-575-6316 WITH ALL RELATED REPORTS. http //www. Jcc.hhsc.ca/body. cfm id 131 Please Print Patient s Name M Health Card Number or non-OHIN information F Date of Birth dd/mm/yy Version Code Language if English not spoken City Province Postal Code Phone primary Phone secondary Address Patient Location Institution Home...
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01
Visit our website and click on the 'Cancer Treatment' tab
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Determine if you meet the eligibility criteria for our treatment
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Fill out the online application form with your personal and medical details
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Submit the application form along with any required supporting documents
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If approved, you will receive further instructions on how to proceed with accessing our cancer treatment
Who needs accessing our cancer treatment?
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Individuals who have been diagnosed with cancer and are seeking effective treatment options
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People who may have tried other treatments with limited success
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Individuals who are looking for a comprehensive approach to cancer treatment
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What is accessing our cancer treatment?
Accessing our cancer treatment involves patients receiving treatment and care for cancer from healthcare providers and facilities.
Who is required to file accessing our cancer treatment?
Patients who are receiving cancer treatment are required to fill out accessing our cancer treatment forms.
How to fill out accessing our cancer treatment?
Accessing our cancer treatment forms can be filled out by providing information about the type of treatment received, healthcare providers involved, and any side effects experienced.
What is the purpose of accessing our cancer treatment?
The purpose of accessing our cancer treatment is to track the care and treatment received by cancer patients in order to improve quality of care and outcomes.
What information must be reported on accessing our cancer treatment?
Information such as treatment received, healthcare providers involved, side effects experienced, and outcomes must be reported on accessing our cancer treatment forms.
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