Document downloads

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This page provides links to Medicor Cancer Centre’s “fillable” PDF files which can be downloaded, filled in and returned to Medicor. Completed forms can be faxed back to us at +1-416-227-1915, emailed, or printed and sent by mail.

New Patient Forms – Remote Consult
New patients unable to attend the Medicor office in person for consultation: please download and fill in these forms. The completed forms should be returned to the Medicor office (by email or fax) in order begin the consultation process.

New Patient Forms – Office Visit
New patients preparing for consultation at Medicor: please download and fill in these forms. The completed


DCA Consent Form
If you have cancer and wish to be treated with with Sodium Dichloroacetate (“DCA”), please download and complete this form.

DCA Frequently Asked Questions
To learn more about Dichloroacetate Sodium (DCA) please click to download this document.


LDN Consent Form
If you have cancer and wish to be treated with Low Dose Naltrexone (“LDN”), please download and complete this form.

LDN Frequently Asked Questions
To learn more about Low Dose Naltrexone (“LDN”) please click to download this document.


USA Insurance Billing
American patients: please fill out and submit this 2-page form to AMHA if you wish to have them bill your insurance company on your behalf.

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