PDF version

Share this information with everyone on your team.

Important numbers:

My Name:____________________________________________

My Partner or Caregiver:________________________________
Phone:________________________________________________

My Cancer Doctor:_____________________________________
Phone:________________________________________________

My Radiologist:________________________________________
Phone:________________________________________________

My Nurse:____________________________________________
Phone:________________________________________________

My Dentist:___________________________________________
My Dental Hygienist:___________________________________
Phone:________________________________________________

My Social Worker:_____________________________________
Phone:________________________________________________

Other Important Telephone Numbers:

National Oral Health Information Clearinghouse:
301-402-7364

Cancer Information Service:
1-800-422-6237

Remember: For your pretreatment dental exam, ask your cancer doctor or radiologist to send the information below to your dentist:

• Your diagnosis
• Your blood counts
• Important head and neck x-rays
• Your treatment plans
  - radiation therapy
  - chemotherapy