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.
