NHS Pan Birmingham Cancer Network

Two week wait urgent referral forms

In response to the publication of the NICE Referral Guidance for Suspected Cancer in 2005, Pan Birmingham Cancer Network has developed a generic referral form for each tumour site treated within the Network. All forms are based on the NICE guidance and should be used in conjunction with this, which can be found at the link above.
Your right: urgent two-week referral - patient information leaflet

This leaflet produced by the Department of Health should be given to patients referred under the two week wait policy. It sets out what patients can do to ensure they are seen quickly and what they can do if they are not.
Brain & CNS referral form

For the PBCN referral guideline to neuro-oncology services please click here.
Breast referral form

For the PBCN referal guideline to breast services please click here.
Children's cancers referral form (brain and CNS)

For the PBCN referal guideline to children services please click here.
Children's cancers referral form (haematology)

For the PBCN referal guideline to children services please click here.
Children's cancers referral form (solid tumours)

For the PBCN referal guideline to children services please click here.
Colorectal referral form

This guideline is currently under development, for more information please contact Lara Barnish.
Gynaecology referral form

For the PBCN referral guidelines to gynaecology services please click here.
Haematology referral form

For the PBCN referral guidelines to haematology services please click here.
Head & neck referral form

For the PBCN referral guideline for patients with suspected head and neck cancer click here, or for those with a neck lump please click here.
Lung referral form

For the PBCN referral guideline to lung cancer services please click here.
Sarcoma referral form

This guideline is currently under development, for more information please contact Lara Barnish.
Skin referral form

For the PBCN guideline on management of skin lesions in the community, and referral to secondary care please ckick here.
Upper gastro-intestinal

This guideline is currently under development, for more information please contact Lara Barnish.
Urology referral form

For the PBCN referral guidelines to urological services please click here.

Referral forms