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You may refer a patient to our diagnostic assessment program with:

• Suspicious nodule(s)/ lesion/ mass on CT thorax (Lung)
• Biopsy proven gastric cancer or high grade dysplasia
• Biopsy proven esophageal cancer or high grade dysplasia

Prior to referral:

• CT scan-Thorax completed (lung)
• Pathology report (Gastric and esophageal)

Please provide if available:

• Pathology report (lung)
• Pulmonary function tests (PFTs) (lung)
• Chest X-ray (lung)
• CT abdo/pelvis (gastric)
• CT thorax (esophageal)

Please fax completed Referral Form to 613-737-8643

Cancer Program Referral Guide

Last updated on: July 21st, 2020