New Patient Referrals

We are here for you and your family during this time of uncertainty. Fill out the referral below to begin receiving services for you and your family.

The Children’s Cancer Center recognizes that the journey that you and your family are experiencing is unexpected and overwhelming. The Children’s Cancer Center is here for you and your family during this time of uncertainty. 

If your child is treated at one of the following hospitals, please fill out the New Patient Referral document below.

Johns Hopkins All Children’s Hospital

Johns Hopkins Outpatient Care, Tampa

Moffitt Cancer Center

St. Joseph’s Children’s Hospital

Tampa General Children’s Hospital

Upon completion, your family will receive a welcome email from a member of our Programs and Family Services team containing comprehensive information about the Children’s Cancer Center.  Additionally, you will be added to the appropriate communications channels, enabling you to immediately benefit from the programs and services tailored to your family’s needs. We understand how isolating this diagnosis can be, and we would like to welcome you into this community so that you can begin receiving necessary support outside of just medical care – because we all know that it takes more than medicine to be well.

 We look forward to providing your family with the emotional, financial and educational support necessary to cope with this diagnosis.

New Patient Referral Form