OHC Patient Referral Form

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Is this referral:
- Urgent (24 hours)
- Immediate (48 hours)
- First Available (72 hours)
I'd like to refer my patient to:
or
- the best available OHC physician
I Am:
Name*
Phone
Email*
Fax
My Patient Is:
Patient Name*
Date of Birth*
Gender*
- Male
- Female
Patient Phone*
Patient Email*
May OHC contact patient directly?
- Yes
- No
My Initial Diagnosis Is:
Diagnosis*
Has Insurance Referral Been Completed (if required)?
Referred for

Patient Follows Through on a Hunch and Gets Expert Help From OHC for Cervical Cancer

February 13, 2020

Charlene Crank always took good care of her health. Then, about five years ago, she began having problems related to her...

OHC was the first independent adult cancer group in the region to bring the ground-breaking CAR T-cell therapy to adults with blood cancers. It’s been more than a year, so is this approach to treatment here to stay?

February 13, 2020

In 2018, OHC was the region’s first adult cancer group to offer chimeric antigen receptor T-cell therapy (CAR-T) to...