Medical Oncology

New Patient Referral Form


Please submit this form to refer your patient to Dartmouth Cancer Center for a second opinion, consultation, treatment, or follow-up care at the following locations:


Dartmouth Cancer Center

Hours: Monday through Friday, 8 am to 5 pm

Phone 603-650-6272

Fax 603-727-7814


Norris Cotton Cancer Care Pavilion, Lebanon

Dartmouth Hitchcock Medical Center

One Medical Center Drive

Lebanon, NH 03756

Phone: 603-653-3500



Dartmouth Cancer Center Manchester

Notre Dame Pavilion, Catholic Medical Center

87 McGregor Street

Manchester, NH 03102

Phone: 603-629-1828


Dartmouth Cancer Center Nashua

Dartmouth Hitchcock Clinics Nashua

2300 Southwood Drive

Nashua, NH 03063

Phone: 603-577-4170


Dartmouth Cancer Center St. Johnsbury

1080 Hospital Drive

St. Johnsbury, VT 05819

Phone: 802-473-4100

Fax: 802-473-4109

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Required Information

Please attach lab reports, pathology reports, imaging reports, and office notes.

Drag and drop files here or