Referrals to the Brantford Cancer Clinic are sent to Hamilton (Juravinski) where they are distributed to the appropriate locations for the patients to receive treatments.

Please include all required information; any incomplete forms will be sent back with notes to the referring physician.

Cancer Clinic Referral Form

Referrals to the Brantford Lung Diagnostic Program (DAP) are sent to Hamilton for triaging and distribution of patients to the closest, most appropriate centre. Please include all required information (past medical history, list of current medications, recent bloodwork if available, imaging that led to the suspicion of cancer) to allow for quick diagnosis and treatment.

LDAP Referral Form

Clinic Fax Number: 519-751-5588

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