Referral Guidelines and Forms

Referral Guide for Clinicians

 

Effective June 1, 2026, CancerCare Manitoba (CCMB) has implemented new referral guidelines for each Disease Site Group (DSG). Please refer to the updated referral forms and the minimum requirements outlined for each DSG prior to submitting your referral.

Please note: Acute leukemias should be referred directly by phone consultation to the on-call Leukemia/BMT Service Attending Physician at the Health Sciences Centre.
                                                

The CCMB Central Referral Office serves all CCMB locations across the province including the Western Manitoba Cancer Centre Radiation Oncology Program. It is a central point of entry for referring physicians & nurse practitioners to access CCMB clinical services for patients requiring consultation. Patients requiring consultation can be new patients, re-referred patients and patients who were previously discharged.

Referral Forms and Guidelines by Disease Site Group

Emergent Referrals

If the referral is emergent, please phone  the “on call”  medical or radiation oncologist, gynecologic oncologist,  surgical service or hematologist through paging for Health Sciences Centre at 204-787-2071 or St. Boniface Hospital paging at 204-237-2053.

For emergent pediatric referrals (prior to 17th birthday), please page the on call pediatric oncologist/hematologist through Health Sciences Centre at 204-787-2071.

Non-Emergent Referrals

The referral, together with the accompanying clinical diagnostic information, should be faxed to CancerCare Manitoba's Referral Office at 204-786-0621.

Central Referral Office

Monday to Friday
8 a.m. to 4 p.m.
Closed on statutory holidays.

General Inquiries
Phone: 1-844-320-4545
Fax: 204-786-0621

Emergency Referrals
Health Sciences Centre paging:
204-787-2071 or
St. Boniface Hospital paging:
204-237-2053

Lack of pertinent data MAY DELAY the referral process along with scheduling of the patient's appointment.

If the referring physician has ordered investigations that have not yet been completed or results are pending, please provide dates and location of procedures if known.

* For patients who require a CCMB consult appointment, the patient will be contacted directly with their appointment details.

* If the referred patient does not necessitate a clinic appointment, a letter may be sent back to referrer with recommendations for care.

In addition to the CCMB referral guidelines for non-emergency and emergency referrals, referring health care professionals may download the required information relative to each case they refer. Please refer to the specific disease site groups below.

Cancer Navigation Services Regional Referral Forms

Interlake Eastern Regional Health Authority
1-855-557-2273
IERHA Referral Form		 Northern Regional Health
1-855-740-9322
NRH Referral Form		 Prairie Mountain Health
1-855-346-3710
PMH Referral Form
Southern Health - Santé Sud
1-855-623-1533
SH-SS Referral Form		 Winnipeg
1-855-837-5400
Winnipeg Referral Form