Benign Hematology Referral

PATIENT INFORMATION


REFERRAL INFORMATION AND SUPPORTING DOCUMENTATION

*If the reason for referral is anemia, please specify the underlying cause, if uncertain, include what work up was done.




Referral Packet

Please include the following information in the referral package. Please fax to (505) 272-5458. Incomplete referral may delay appropriate triage and referral time.



REFERRING PROVIDER INFORMATION


Attention Referring Providers: Dr. Ebaid is available to discuss the case and answer your questions if you are uncertain if your patient requires a referral to hematologist or how urgent the referral is. Call (505)272-2000 and provide your contact information to be connected to Dr. Ebaid.