Leukemia and Lymphoma Cancer Referral Information for Providers
To refer a patient or for assistance in navigating the Virginia Mason Health System, we have several resources available for your convenience:
- Online Physician Referral Form
- Patient Referral Fax Form — Fax: (800) 641-9002
- Phone: (877) 333-0122
Please ensure that you include the following pertinent information:
- History and Physical/Chart notes
- Medication /Allergy List
- Lab Results
- Pathology Reports
- Radiology Reports (CT, MRI, X-Ray, US, and HIDA)
- Patient Demographics
Online Physician Referral Form
Note: Online submission form ONLY.
Please DO NOT PRINT and fax in this form.
If faxing a referral, use the Patient Referral Fax Form.
