What information do I need to create a Treatment or Survivorship Care Plan?

You will need the information listed below to complete a Treatment or Survivorship Care Plan.

Please note: A Cancer Care Plan is intended to be a summary document whose purpose is to assist the healthcare team in coordinating care for the patient after active treatment ends. A Cancer Care Plan does not replace the medical record and a complete medical history provided by the patient.

  1. General Information: Contact information for the patient and their care team. This is important for the coordination of care.
  2. Background Information: Basic information on the patient’s medical background and diagnosis, including family history, genetic testing, surgeries, chemotherapy and other health concerns. Again, this is not comprehensive or meant to replace the patient's complete medical record.
  3. Treatment Plan: Key information about the planned course of cancer treatment.
  4. Treatment Summary: Summary information describing the actual course of treatment, including changes to the treatment plan, serious toxicities, hospitalizations during treatment, additional surgeries and medications.
  5. Follow-Up Care: The follow-up testing schedule, preventive care recommendations, and any additional needs, concerns, interventions or referrals.