Cancer care manitoba referral: Fill out & sign online

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Click ‘Get Form’ to open the Referral Forms & Guidelines in the editor.
Begin by filling out the General Information section. Enter the patient's demographic details, including their name, date of birth, and contact information. Ensure all required fields are completed.
Next, attach any necessary Pathology Reports. Use the upload feature to include original reports such as diagnostic biopsy and Pap smear cytology if applicable.
Proceed to the Operative Reports section. Input details from the procedure note related to any diagnostic biopsies performed.
In the Imaging Reports section, provide results from chest x-rays and other staging investigations as required.
Complete the Bloodwork section by entering CBC and biochemistry results. If tests are pending, indicate dates and locations in the designated space.
Finally, ensure that the referring physician signs the form electronically before submitting it via fax or email as instructed.

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What information should you include in a referral?

How do you make the referral? Relevant details of the person youre concerned about. Your involvement with the person(s) youre concerned about. The nature of the concern, expressed in a clear and concise way.

What information is included in a referral form?

It usually includes the patients personal information (e.g., name, age, address etc.), their medical history, the reason for the referral, and the referring doctors information.

What are referral forms?

Your referral should include: up-to-date information about your health issue. the date of the referral. the reason for the referral.

What are the four key elements of making a referral?

Here are the four essential steps in the referral process: word-of-mouth referrals, online reviews, social recommendations and sharing, and email referrals.

What information is included in a written or electronic referral form?

When referring a patient to a specialist or consultant physician for treatment, the referral must include: relevant clinical information about your patients condition for investigation, opinion, treatment and management. the date of the referral. signature of the referring health professional.