Thank you for referring your patient to Nebraska Hematology-Oncology. Once the form is submitted to us, your patient may call us to set up their appointment or you may request NHO to call your patient to schedule the appointment. If you have any questions, please call us at 402-484-4900 and select option 4 to speak with New Patient Scheduling.
FAX REFERRAL FORM
Complete the appointment request form and fax to 402-817-0189 or email to medrecords@yourcancercare.com. Please also include:
- Office notes from the last two years
- Labs from the last year
- Diagnostic testing
- Demographic information and insurance cards
