Your First Visit to the Cancer Centre

Forms to Complete Before Your First Visit 

At the Saskatchewan Cancer Agency, your health and safety are our priority. To help us best plan your cancer care and treatment, we need information, including your medical history, family medical history and lifestyle information. Please complete and submit the following forms (also available in the resources section below) before your first appointment at the cancer centre.

Please Note: These forms are only intended for patients who have already been referred to the Allan Blair Cancer Centre or Saskatoon Cancer Centre. 

1. Personal Health History Form

Please complete and submit the personal health history form before your first visit to the cancer centre. 

You can complete the form:

  • Online by clicking HERE;
  • Print it and fill it out by hand; or 
  • Submit it electronically. Follow the steps below on how to complete the form electronically.

This form is three pages in length and will take approximately 15-30 minutes to complete. Please complete all sections as thoroughly and accurately as possible. If information is missing, we may need to call you in advance of your appointment to follow up. Your care team will review all of the information that you have provided at the time of your appointment.

2. Personal Medication List

We ask that you complete and submit the personal medication list two days before your first visit to the cancer centre. 

 Click here to download the personal medication list. 

  • Print the form and fill it out by hand; or
  • Fill out the form electronically. Please follow the steps below on how to complete and submit the form electronically.

The form is two pages in length. Please complete all sections as thoroughly and accurately as possible. If your medication review appointment is scheduled over the phone, please have this list with you for any clarification or questions. The completed form does not replace your medication review appointment.  

3. New Patient Form

Click here to download the new patient form.

Submitting the Forms

Once your forms are completed, email them to patienthistory@saskcancer.ca. Please include your town/city in the subject line of the email. After emailing the forms, you will receive an automated notification confirming that your forms have been received. NOTE: This email will not respond to inquiries. 

If you need assistance filling out the forms, contact the cancer centre closest to you and ask to speak to a member of the Intake Team.

Electronic Submission of New Patient Forms

Completing the Forms Electronically:
  1. Ensure your computer has Adobe Acrobat Reader DC. You can download Adobe for free at https://acrobat.adobe.com/ca/en/acrobat/pdf-reader.html
  2. Click the Personal Health History Form or Personal Medication List link on the website. This will open the form in your Internet browser.
  3. Save the form to your computer. We do not recommend saving the form on a public computer.
  4.  Close your Internet browser.
  5. Complete the form as thoroughly and accurately as possible.
  6. Save the completed form to your computer.
  7. Close the document.
How to Send the Forms:
  1. Open a new email.
  2. In the To field, type the email address: patienthistory@saskcancer.ca
    - In the Subject field, type your name and city, e.g. Jones – Yorkton
  3. Attach the completed Personal Health History Form and/or Personal Medication List (look for the Paperclip icon to attach files)
  4. Send the email.
  5. You will receive a notification that the email has been received. Do not reply to this email.

Privacy and Consent

The information being requested on the forms is required to ensure we can properly identify you and meet your needs for care. More details about our information management practices are available at www.saskcancer.ca/privacy. By downloading, completing and submitting the health history form, you agree to the collection, use and disclosure of your personal health information by the Saskatchewan Cancer Agency for these authorized purposes.

Frequently Asked Questions

Who can I contact if I am having issues with completing the forms?
Contact the cancer centre closest to you and ask to speak to a member of the Intake Team.

What if I don’t have a computer?
A member of the cancer centre’s Intake Team will call you and take your information over the phone.

Can I print the forms and send them in the mail?
No, do not send the forms by mail. Please print the forms, complete by hand and bring to your first appointment. Please have the Personal Medication List with you if your medication review appointment is scheduled by phone.

Does a completed Personal Medication List replace my medication review appointment?
No. The completed list will be reviewed with you during your medication review appointment, whether in person or on the phone. It does not replace your appointment.

Additional Resources