New Patient Referral
A physician’s referral is not necessary, but always welcome.
Referring physicians are asked to fax the following information to (260) 446-3659 or send as a direct message to: admin@fwmoh40.OncoEMRDirect.com
- Referring physician office notes
- Medication list
- Surgery Report
- Labs
- Pathology reports (including ER/PR/Her2/neu/FISH or any special stains)
- Oncotype Dx (if performed)
BRCA 1, BRCA 2 testing (if done) - Mammogram
- Breast MRI and/or Ultrasound
- Any additional radiology reports pertaining to breast cancer diagnosis
- Pulmonary Function Test
- Any PET CT CXR Scans and radiology reports pertaining to hematologic diagnosis
- If DVT diagnosis, please include all ultrasounds the patient has relating to the DVT diagnosis
- Copy of the patient’s insurance card
