Referral information

Please complete the CAR-T referral form and submit the completed form following the instructions provided.

In addition, please attach the following:

• Referral letter stating the date of diagnosis/transformation, prior lines of treatment and response, and any active or chronic comorbidities and medications
• Recent or relevant PET/CT/MRI reports (screenshot of PET images if possible)
• Recent TTE or MUGA if available
• Relevant histopathology reports
• Recent FBE, EUC and LFTs

Once the patient referral has been submitted, referrals will be triaged by one of our CAR-T Haematologists and you and your patient will be contacted.

Patients will be required to be reviewed in person in our CAR-T clinic to assess eligibility, along with any screening investigations if not already performed.

All new referrals will be discussed at the Alfred multidisciplinary meeting as well as the National CAR-T multidisciplinary meeting.