Book Appointment - Kano Cancer Treatment Centre

BOOK AN APPOINTMENT

Patient Information

First Name

Last Name

Phone

Email

Referring Physician/Doctor's Information

If you have been referred by a doctor, please enter their details below.

Doctor's First Name

Doctor's Last Name

Doctor's Phone Number

Doctor's Email

Document Upload

Upload any relevant documents.

Proof of Payment

Referral Letter

Biopsy/Histology Report (if available)

Any additional files