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Cancer Care Appointment Request

Thank you for your interest in the Duke Cancer Institute. We understand you may have a lot of questions and we are here to help. If you are a new patient, please fill out this form to request an appointment for cancer care at Duke.

This form should take less than 5 minutes to complete. Once you complete this form, we will call you within two business days and connect you to the right team of experts.

We appreciate you trusting your care to us. 
 

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Opening Questions

Are you the patient?*
If you are the patient, you will skip to page 3 when you continue.
Is the patient a US citizen or a lawful permanent resident of the US?*
Has the patient had an appointment at the Duke Cancer Institute within the last 3 years?

Do Not Continue

International patients: Please complete this form.

 

Please Use MyChart

Returning Patients: Please log in to MyChart to request a new appointment. If you haven't registered for MyChart yet, please visit this link to get your account activated.