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Cancer Referral Forms

 

Cancer Referral Forms

Please find listed below referral forms for all tumour sites.

 

Please note that forms should be faxed to Choose and Book.  Apart from sarcoma referrals which should be directed to The Royal Liverpool Hospital, brain and CNS referrals which should be directed to the Walton Centre and upper GI referrals which should be e-mailed to wih-tr.directscope@nhs.net.

 

Wirral Choose & Book Details are:

Fax:     604 7172

Phone:  604 7720

 

Family History Referral Forms (WUTH)

Breast Family History Referral Form

Colorectal Family History Referral Form

 

Suspected Cancer Referral Forms (WUTH)

Suspected Breast Cancer Referral Form

Suspected Colorectal Cancer Referral Form

Suspected CUP and MUO Cancer Referral Form

Suspected Gynaecological Cancer Referral Form

Suspected Haematological Cancer Referral Form

Suspected Head & Neck Cancer Referral Form

Suspected Lung Cancer Referral Form - only to be used if the patient has had imaging suggestive of cancer elsewhere. Please follow this pathway for lung cancer referral

Suspected Skin Cancer Referral Form

Suspected UGI Cancer Referral Form

Suspected Urological Cancer Referral Form

 

Suspected Cancer Referrals Additional Information (WUTH)

Suspected Cancer Referral Patient Leaflet

Suspected Skin Cancer Referral Information

Suspected Upper GI Cancer Referral Information

 

Suspected Cancer Referral Forms (Other Trusts)

Suspected Brain and CNS Referral Form

Suspected Sarcoma Referral Form

 

North West Coast Strategic Clinical Network for Cancer

North West Coast Cancer Network Protocols, Information, Guidance and Resources

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