PHYSICIAN REFERRAL
Refer a Patient for Clinical Trial Consideration
Referring a patient? Use this form to share information with Taylor Cancer Research Center and begin the review process for precision therapy clinical trial consideration.
Please include any additional relevant information in the message section. If a patient or caregiver is submitting directly, they should use the Self Referral page instead.
What to have ready
To help us begin review as quickly as possible, please attach the following, if available:
1. Last office note
2. Molecular testing report
3. Last imaging report
Physician Referral
What happens after you submit
Once your information is received, the TCRC team will review the materials provided and determine whether additional information is needed. If a clinical trial opportunity is a fit, a member of the team will follow up with next steps.
Need help before you begin?
If you have questions about the referral process or would prefer to speak with someone directly, please call 567-402-4500.
Who should use this page
This page is for providers referring a patient for clinical trial consideration at Taylor Cancer Research Center.
Who should not use this page
If a patient or caregiver is submitting information directly, they should use the Self Referral page instead.
Ready to submit a referral?
Complete the Physician Referral form to begin review, or call Taylor Cancer Research Center directly if you have questions before getting started.