Head and Neck Cancer

Diagnosis
Head and neck cancer
Department
Hematology and Medical Oncology; Otolaryngology and Head and Neck Surgery

1. Start the referral process:

Use your own referral form or notes* or download our form:

Adult referral form

    2. Gather records:

    For Hematology and Medical Oncology:

    • Pathology/Scans

    For Otolaryngology and Head and Neck Surgery:

    • Any chart notes and imaging related to referral
    • If pathology was done, slides should be requested

    3. Fax the referral and all records to 503-346-6854.

    * Referral notes or forms should include:

    • Patient name, date of birth, sex, address and phone number
    • Referring provider’s name, address and phone number
    • Diagnosis or reason for referral
    • Department patient is being referred to
    • Most recent chart notes supporting the diagnosis or reason for referral

    For help or to arrange provider-to-provider advice, call 503-494-4567.

    Date Revised May 01, 2024