Sarcoma Clinic

Groote Schuur Hospital Specialist Sarcoma Clinic Referral

This form is to be completed for all submissions to the Groote Schuur Hospital Specialist Sarcoma Clinic. The form must be completed by a registered medical practitioner. Self referrals will not be accepted.
Important information - COVID ALERT

Groote Schuur Hospital Outpatient Clinics has been affected by the COVID pandemic again. Staff has been reallocated from outpatients to support the wards. As a result, we have been forced to de-escalate our clinic. Routine bookings will be available from September 2021. If you have a patient you feel needs to be seen urgently please send us an e-mail to breastsurgendo@gmail.com
Important information

Appointments for patients with possible sarcoma should be available with a waiting time not longer than 14 days. If appointments are not available and you would prefer a booking at an earlier date please send us an e-mail to breastsurgendo@gmail.com
I hereby agree to receive updates and future information regarding the Groote Schuur Sarcoma Clinic to the email address provided later*

YesNo
Referring Health Care Worker Information
Name referring health care worker*

PrefixFirst NameLast Name
Health Professional Council / South African Nursing Council Registration Number*
Day hospital / Clinic / Hospital / Practice where the patient is referred from*
Email referring health care worker*
example@example.com
Phone Number referring health care worker*
Patient Information
Does your patient have an existing Groote Schuur Hospital or clinic or number?*
Hospital / Clinic Number*
Name of patient*

First NameLast Name
Birth Date of patient*

DayMonthYear
Gender*

MaleFemale
Cellphone or home number of patient (NOTE If no contact number available use 021 123456)*

Referral information
Main reason for referral*

Suspicious soft tissue tumour (extremity)Suspicious abdominal massAtypical lipoma

Soft tissue mass
Most soft tissue masses are lipomas.

Soft tissue tumours that may be sarcomas are usually: >5cm, deep to muscle, fascia, firm and rapidly growing.
If you are concerned about a soft tissue sarcoma, please make an appointment by selecting 'Proceed to booking' below*

Proceed to booking

Abdominal mass
There are many causes of an abdominal mass with sarcoma being one of the rarer causes.
Has the patient had an ultrasound or CT of the abdomen showing a mass?*

YesNo

Your patient needs imaging before referral

Please refer your patient to the nearest hospital for the relevant imaging before referring the patient to us again. If Groote Schuur Hospital is you primary referring hospital for imaging please contact us on breastsurgendo@gmail.com for an appointment.

Please provide the patient name, DOB, and hospital number in all correspondence.

Atypical lipoma
Patient probably has a lipoma but it is atypical in that it is large, rapidly growing or deep seated and therefore needs specialist evaluation.*

YesNo

Please Note

There is no need for a Sarcoma Specialist clinic referral. Please refer your patient to your nearest General Surgery OPD (SOPD)

Referral letter
Please make sure you provide the patient with a handwritten referral letter and instruct them to bring it with them to the consultation. You can upload additional information if you want, just make a note on the referral letter to make us aware that you uploaded additional information.
Upload file

Cancelof
Appointment
PLEASE NOTE

Make sure you select a date and time slot on the calendar. Once you have selected a time slot a blue box should appear below the calendar reading "You’ve selected 7:00 AM on Wednesday and date" If you now hit submit your patient is booked. All patients should be at the clinic before 07h00.
PLEASE NOTE

Please make sure you click Submit after selecting a date and time.
Should be Empty:

Groote Schuur Hospital Specialist Sarcoma Clinic Referral

Referral information

Soft tissue mass

Abdominal mass

Atypical lipoma

Referral letter

Appointment