Follow the steps to complete the PRC 42 Breast form online.

1. Click ‘Get Form’ button to obtain the form and open it in a suitable editor.
2. Begin by filling out the patient information section, including the last name, first name, date of birth (DOB), maiden or previous name, sex, and OHIP or other identification details. Ensure accuracy in the data entered.
3. Provide the patient's address, including the city, province, and postal code. Make sure to include contact numbers for home and work as well as a contact person if necessary.
4. Indicate if the patient has special needs by checking the relevant options (e.g., oxygen, wheelchair, stretcher). If an interpreter is needed, select 'Yes' and specify the language.
5. Complete the referral information section by selecting the cancer type and indicating urgency by selecting either 'Standard' or 'Urgent.' Provide a reason for urgency in the comments section if applicable.
6. In the clinical information section, enter the date and institution. Specify if a core biopsy or fine needle aspiration has been performed, and if further surgery is planned.
7. Request necessary reports by checking the appropriate boxes for operative procedures, surgical pathology, and relevant markers. Indicate if these are attached or pending.
8. Fill out the referring physician section, including reports requested for imaging tests. Ensure all necessary attachments are noted.
9. Finish by signing the form, providing your printed name, signature, date, telephone, and fax numbers, and confirm that the patient has been informed of the referral.
10. Review all entered information for accuracy, then proceed to save changes, download, print, or share the form as required.

Complete your documents online for a seamless referral experience.