Information Request Form – Ask for Ana


Tackle Cancer with Radiation Therapy


IMPORTANT: If you are experiencing a serious medical emergency, call 911.

Studies show that patients treated at specialized hospitals have better results. That’s why at Sylvester Comprehensive Cancer Center, we tackle cancer. Only cancer.

To receive information on a specific kind of cancer and the specialized care available at South Florida’s only university-based cancer center, complete this form. One of our “Ask for Ana” cancer care coordinators will contact you to answer any questions you might have and help you arrange your first visit.


Name:  

Phone:   (format 1234567 no spaces or dashes)

E-mail:

Message: (Optional)
 

Please contact me with information about this type of cancer:

I would like to schedule an appointment with a Sylvester cancer specialist.

Please contact me about clinical trials.

Information collected from this website will be used by Sylvester Comprehensive Cancer Center only in order to process your request.
This is a secure site and your information will be kept confidential.

In order to confirm that you have read and agree to the above, please type  AGREE  in the box:

 

Disclaimer:
The content published by the Sylvester website is for informational purposes only. Readers are encouraged to confirm the information contained herein with other sources. Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by physicians. Sylvester and the University of Miami will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising there from.