Hematology referral form 2026

The document outlines the referral process for hematology services in Manitoba, provided by CancerCare Manitoba. It specifies that uncomplicated iron deficiency anemia does not require a hematology clinic assessment and should be referred for gastrointestinal investigation instead. Emergent referrals must be made via direct phone call, while non-emergent referrals are to be faxed to the Central Referral Office. The document details required information for referrals, including patient history and necessary bloodwork, and emphasizes that the referring healthcare provider remains responsible for the patient until they are seen in the clinic.

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Click ‘Get Form’ to open the hematology referral form in the editor.
Begin by filling out the patient information section. Include details such as surname, given name, date of birth, and contact information. Ensure all fields marked as required are completed.
In the referral information section, specify the diagnosis and reason for consultation. Indicate whether the diagnosis is confirmed or presumptive and if the patient is aware of their diagnosis.
Attach any necessary documents such as pathology reports and previous medical history. Use our platform’s upload feature to easily add these files.
Review all entered information for accuracy. Make sure that all required fields are filled out to avoid delays in processing your referral.
Once completed, save your changes and utilize the fax option to send it directly to CancerCare Manitoba’s Central Referral Office.

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Why would I be referred to hematology?

What to Expect During an Appointment With a Hematologist. Being referred to a blood oncologist does not necessarily mean that a patient has a serious illness. Instead, it means there were concerning irregularities in the patients blood test results that need to be investigated.

What is a hematology referral for?

Youll most likely be referred to one by your primary care doctor. Reasons include if you have or might have: Anemia, or low red blood cells. Deep vein thrombosis (blood clots) Leukemia, lymphoma, or multiple myeloma (cancers in your bone marrow, lymph nodes, or white blood cells)

What should be on a referral form?

It includes information about the referring provider, the patients personal information, the reason for referral, referral details, and additional medical information.

Why would I have a hematology appointment?

What is the most common type of blood disorder? Anemia represents the most common type of noncancerous blood disorder. The U.S. Centers for Disease Control and Prevention estimates about 3 million people in the U.S. have some type of anemia. Anemia happens when you dont have enough healthy red blood cells.