Acquired Hemophilia

Diagnosis
Acquired hemophilia
Department
CDRC Hemophilia

1. Start the referral process:

Use your own referral form or notes* or download one of our forms:

2. Gather records:

  • Recent clinic notes
  • Labs
  • Diagnostic imaging

3. Fax the referral and all records to 503-346-6854

* Referral notes or forms should include:

  • Patient name, date of birth, sex, address and phone number
  • Referring provider’s name, address and phone number
  • Diagnosis or reason for referral
  • Department patient is being referred to
  • Most recent chart notes supporting the diagnosis or reason for referral
Date Revised February 17, 2021

Refer a patient

  • Fax your referral to 503-346-6854.
  • For help or to arrange provider-to-provider advice, call 503-494-4567 , option 4.