CBCC | Make An Appointment | Outsmarting cancer

Outsmarting Cancer Together.

Make an Appointment

Patients come to the Comprehensive Blood and Cancer Center by physician referral or self-referral. Either way, the forms below will be used to enter your information into our system.

Physician Referral

A member of our Patient Navigation team will contact you to begin the new patient process on the same day we receive a referral from your physician.

Self-Referral

You can call our office at (661) 322-2206 to schedule an appointment. Our Patient Navigation team will begin the new patient process that same day. Be sure to have your insurance information and physician contact information available.

New Patient Forms

Download the new patient packet or individual forms below. These forms are fillable. Download to save a copy to your desktop. Complete the form and print it out or select "Save As" after completing the form to save a copy of the completed form.

Download the Entire New Patient Packet
Health & Medical History
Patient Information Form
Release of Patient Medical Information
Release of Medical Records
Advance Health Care Directive

These files are in PDF Format. Abobe Acrobat Reader is required to view. Download Acrobat Reader here.

Get Adobe Acrobat Reader

Need Help? Call Us!

Main Line

(661) 322-2206

Patient Navigation

(661) 865-2573
Contact Us