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Referral Information

The primary referral area for the GRRCC is the Region of Waterloo, Wellington County and surrounding communities.

Please select from the referral forms below.

GENETIC COUNSELING REFERRAL FORM

For health care providers, click here for the Ministry of Health and Long Term Care guidelines for referral to cancer genetics services, and our referral form in PDF format. Certain referrals for rare inherited cancer syndromes may be redirected to one of the larger provincial genetics programs.

WATERLOO WELLINGTON BREAST CENTRE REFERRAL FORM

This is the new requisition for referring your patients to the new regional Waterloo Wellington Breast Centre. We have added a map on the back of this referring requisition to provide easy directions for your patients.

Click here to download the form in PDF format.