Physician Referral Forms

Breast Cancer Care

Care is provided through an Integrated Care Collaborative (ICC), a system of health care providers, clinics and services focused on breast cancer patients and their families. This focus means patients receive evidence-based care, following best practices in a multidisciplinary, collaborative environment.

Breast Cancer Care PDF Referral Form 
(Please note the online referral form is no longer available, please use the PDF referral form)

Learn more about Breast Cancer Care

Colorectal Cancer Care

FIT Positive Colonoscopy Referral Form

FIT Positive Colonoscopy eReferral (Ocean) 

Central FIT + colonoscopy referral form (PDF)

Colorectal Diagnostic Assessment Program

Colorectal Diagnostic Assessment  Program eReferral (Ocean) 

Colorectal Diagnostic Assessment PDF Referral Form (PDF)

Description of Colorectal Cancer Program

Palliative and Supportive care

Freeman Centre for the Advancement of Palliative Care, In-home Care Referral 

See the Palliative Care Program referral forms (page)

Description of the Freeman Centre for the Advancement of Palliative Care

Prostate cancer care

Gale and Graham Wright Prostate Centre

The Gale and Graham Wright Prostate Centre at the Branson Ambulatory Care Centre is a unique facility offering patients dramatically reduced wait times for assessment, diagnosis, counseling and treatment.

North York General Prostate Centre eReferral (Ocean)

North York General Prostate Centre Referral Form (PDF)

Description of the prostate centre


This central intake referral program expedites access for patients who require a consult with a haematologist or oncologist. Referrals are booked according to the next available physician (unless otherwise indicated) ensuring patients are seen within 2 weeks. Improving access to oncological and hematological services has significant benefit to patients for early diagnosis and possible earlier intervention.

Hematology and Oncology Referral Form (PDF)

Palliative Care Clinic (formally Pain and Symptom Management Clinic)

This clinic is a team of health care providers working with North York General oncologists, surgeons and palliative and supportive care physicians to manage complex pain and symptom issues related to their patients’ care.

Palliative Care Clinic Referral Form (PDF)

Description of the Palliative Care Clinic

Stomach Cancer Care Program

NYGH offers support for patients along their entire journey. We are one of the very few hospitals in Canada to review every single stomach cancer case by a multidisciplinary tumour board.

Stomach Cancer Care Referral Form (PDF)

Description of the Stomach Cancer Care Program