• New patient: you have a medical condition that is or could be cancerous or a blood disorder
• Transfer care: you are moving into the area and need an oncologist/hematologist, or you are currently under the care of a local oncologist/hematologist and would like to transfer care to one of our physicians
• 2nd Opinion: you have been diagnosed with cancer or a blood disorder and would like to get a second opinion on the prognosis and treatment course
• Former patient: if you have not been to the office in 3 years or more, you will need to get a referral sent in by a physician to re-establish care

Send the referral form to your physician to refer and ask them to send with the following items:

• Referral form your physician needs to send
• Your demographics
• Your insurance card (front & back)
• Last office visit note
• Test results/labs/bloodwork/scans/pathology

HAVE THE PHYSICIAN FAX THE REFERRAL FORM ALONG WITH THE DOCUMENTATION LISTED ABOVE TO

*****  FAX # 704-377-0353 *****