CBCC | Make An Appointment | Outsmarting cancer

Outsmarting Cancer Together.

Make an Appointment

Patients come to the Comprehensive Blood and Cancer Center by physician referral or self-referral. Either way, the forms below will be used to enter your information into our system.

Physician Referral

A member of our Patient Navigation team will contact you to begin the new patient process on the same day we receive a referral from your physician.

Self-Referral

You can call our office at (661) 322-2206 to schedule an appointment. Our Patient Navigation team will begin the new patient process that same day. Be sure to have your insurance information and physician contact information available.

New Patient Forms

Download the full patient packet or the individual forms below.

Download the full Patient Packet
New Patient Form
Health & Medical History Form
History of Present Illness Form
Patient Information Form
Request for Release of Medical Records
Pathology Materials URGENT Form
Notice of Privacy Practices
Directions to CBCC
Patient Financial Responsibility Assignment of Benefits
CBCC Collection Policy
California Immunization Registry
Advance Directive Instructions
Advance Directive Form

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Need Help? Call Us!

Main Line

(661) 322-2206

Patient Navigation

(661) 865-2573
Contact Us