Become Our Patient
Thank you for selecting Inland Cancer Center (Inland Hematology Oncology Medical Group, Inc.) for your cancer care. Our compassionate staff will guide you through every phase of your treatment at our practice. To become a patient, you will need to obtain a referral from your primary care provider. Once you have done so, you can call our office at (909) 886-6806 to schedule an appointment or you can request one online.
We see patients Monday through Friday, from 8:45 am to 5 pm. We are closed for lunch from noon to 1 pm and are closed on all major holidays.
If you are a new patient, we encourage you to download new patient forms below, which will save you time in our office.
Established patients may log in to the patient portal to request appointments and update forms. Note: We must register you before you can have access to the portal. Please call our office for instructions.
Patient Registration Forms
Once you have made your initial appointment, you can pre-register by downloading, printing, and completing the forms below prior to your arrival. Doing so will help speed up the new patient registration process.
Please be sure to bring all forms with you to your first visit, along with any diagnostic films or other test results that may have been ordered or performed by another physician.
- Patient Information
- Patient History Questionnaire
- Medical Information Release to Family-Friends
- Member Eligibility Waiver
- Medicare Benefits
- Financial Liability Consent
- Authorization for Use or Disclosure of Health Information
Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat free by clicking on the icon below.