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Referrals

Online Referral Form

Fax Referral Form

Referral Help

Making a Referral

Providers

Referring Your Patient is Easy

Coram has three ways for you to quickly and easily refer a patient. Once your referral is received, an experienced admissions representative will contact you to complete the process.

Phone Referrals
Call our national referral line 800.423.1411 to be connected to your local Coram branch. Local branch information is also available on our Branch Location Finder.

Online Referral Form
For quick, accurate and secure referral submissions, click here.

Fax Referral Form*
To review and download Coram's Fax Referral Forms, click here.


Patients and Caregivers

How can I begin receiving specialty infusion services from Coram?

Coram’s mission is to be the provider of choice for all your infusion needs by giving you a level of service, responsiveness and care that is second to none. If you have questions or have a need for specialty infusion services, contact your local Coram branch and let our team of admission professionals help you meet your needs. With over 75 local branches across the country, we are likely to provide service in your area.

Click here to locate your local branch, or call our national referral line 800.423.1411 to be automatically directed to a local admissions professional. For more detailed online help, click here.


*Faxed prescriptions can only be accepted from the prescribing practitioner. If you are using the Fax Referral Form to self-refer to Coram, a physician's signature and original prescription drug order are required. If materials include Protected Health Information (PHI), these records are CONFIDENTIAL.