Refer Your Patient

San Bernardino Cancer Care Center

Location & Appointment Phone Number


1800 Medical Center Drive, Suite 100
San Bernardino, California 92411
Tel: 909.887.8800
Fax: 909.887.5678

Refer Your Patient

How to Refer Patients

To refer a patient to San Bernardino Cancer Care Center, please call us at (909) 887-8800. You can also download and complete our Patient Referral Form, then fax it to us at (909) 887-5678. Once we receive your form, we will call your patient and schedule an appointment with Dr. Alqaisi. We will keep you informed of your patient’s reason for treatment and progress. Thank you in advance for your patient referral!

Patient Referral Form:
25kb

We appreciate it if you can fax us the following information prior to your referred patient's appointment:

  • Consultation notes
  • Lab and pathology reports
  • XRAY and scan reports
  • Radiology reports and images (bring either the CD or film)
  • Any prior radiation records (if applicable)
  • Treatment records: Chemotherapy; Radiation
  • Operative reports
  • Hospital discharge summaries
  • Copy of your patient's insurance card, front and back
Vicura Oncology LLC Mojave Radiation Oncology Center Orange County Radiation Oncology Center San Bernardino Cancer Center Atlas Medical Physics Rad Onc Vicura Oncology LLC Mojave Radiation Oncology Center Orange County Radiation Oncology Center San Bernardino Cancer Center Atlas Medical Physics Rad Onc
Home Team About Affiliations Links Insurance Location Contact
Treatment Procedures Patient Education FAQ Patients Forms Physicians Site Map
 
San Bernardino Cancer Care Center, 1800 Medical Center Drive, Suite 100, San Bernardino, California 92411
Tel: 909.887.8800   Fax: 909.887.5678