CIBC Breast Centre
Referrals
For health care professionals
Reasons for referral may include:
- A benign breast condition such as:
- Pain
- Infections
- Abscesses
- Nipple discharge
- Benign lumps
- Imaging abnormalities on mammography or ultrasound
- Difficult physical examination
- Risk assessment and screening
- Personalized risk assessment
- Ontario Breast Screening Program (average risk or high risk screening program) and coordination of genetic testing
CIBC Breast Centre referral form
- Download referral form (317 kb pdf file)
OBSP High Risk Screening referral
- Donwload form (pdf file)
Fax this referral form to St. Michael’s Hospital at: 416-864-5788
