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How to refer

A common referral form is available when referring a patient for palliative care services at the Grand River Regional Cancer Centre (GRRCC) or based in the community.

Palliative care referral form

Please fax (519-883-5550) the referral form to the Waterloo Wellington CCAC where it will be triaged and dispersed to the appropriate palliative care team.

Patients referred to the GRRCC Pain and Symptom Management/Palliative Care team are patients that have a life-threatening cancer and are receiving, or will be receiving, disease modifying/life sustaining treatment.

Patients referred to the community PSM/PC team are patients that have a life threatening illness and are currently not receiving any disease modifying treatment. This referral includes community palliative physicians, palliative nursing, PSW etc.

Palliative care team members are available and provide access and support 24/7 with the help of the Community Care Access Centre (CCAC) services and a group of specialty trained palliative care nurses in the community.

For any questions or concerns regarding the referral process, please contact CCAC at 519-883-5500 or the team at the GRRCC at 519-749-4370 ext 5143.

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