Request an appointment at Goshen

We can help you become a patient at Goshen Center for Cancer Care. Simply fill out the self-referral form below or call our Oncology Information Specialist, (888) 492-4673 (HOPE).













If this is a medical emergency please call 911 immediately. Please do not include personal medical information on this form. A Goshen Health Colleague will contact you regarding the details of your request. 

We respect your privacy.

The information that you provide via this website will be strictly confidential and is intended only for the use of Goshen Health in providing care and services to you.