Texas Children's Cancer & Hematology Centers

New Patients

Make a First Appointment

A referral from your physician is required in order to make an appointment at the Vannie E. Cook Jr. Children's Cancer Center and Hematology Clinic.

Why do I need a referral?

We ask that your physician give us a call before your first appointment is made. During this phone call, your child's case is discussed and it is decided how soon the patient should be scheduled for an appointment at the Vannie E. Cook Jr. Children's Cancer and Hematology Clinic. This conversation also helps to determine what laboratory tests will be necessary at the time of the visit.

What to Bring to the First Appointment

• Bring as many of these items as possible to your first appointment:
• Immunization and medical records of the patient
• If x-rays and/or scans have been obtained, please bring a copy preferably on a CD (digital copy) if available
• If available, please bring pathology slides and paraffin blocks
• Insurance cards for proof of insurance
• The Social Security Number of the insurance holder in order to verify insurance coverage
• Please print and complete the following forms and bring them with you. Complete as much of the forms as possible prior to the first visit. This will help speed up the registration process.  

English

• Patient Registration Form

• Patient Authorizations and Irrevocable Assignments (Consent Form)

• Statement of Financial Responsibility/Assignment of Benefits Baylor College of Medicine

• Acknowledgment of Receipt of Privacy Notice

• Authorization for the Use and Disclosure of Protected Health Information

• Medical History Form A

• Medical History Form B

Spanish/Español

• Acuse de Recibo del Aviso de Privacidad

• Autorización para el uso y la divulgación de información médica protegida

• Historia Medico