SELF REFERRAL
Start the Review Process for Clinical Trial Consideration
Interested in one of our clinical trials? Patients and caregivers can use this form to share information with our team and begin the review process.
If you are exploring whether a precision therapy clinical trial may be a fit, this is the right place to start. If you are a physician referring a patient, please use the Physician Referral form 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
Self Referral Form
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 patients and caregivers who want to begin the review process for clinical trial consideration at Taylor Cancer Research Center.
Who should not use this page
If you are a physician referring a patient, use the Physician Referral page so the provider-specific information can be collected from the start.
Ready to take the next step?
Fill out the Self Referral form to begin review, or call Taylor Cancer Research Center directly if you have questions before getting started.