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Referrals

Online Referral Form

Fax Referral Form

Referral Help

Referral Help



Referring a Patient by Phone

Call our CASEDirect national referral line 800.423.1411 to be connected to an experienced admissions professional at your local Coram branch. Detailed local branch information is also available on our Branch Location Finder.

Coram's Centralized Referral Intake Service is also available to provide referral assistance at 303.672.8660, M-F 6:30am – 4:00pm MST.



Referring a Patient by Fax

Infusion Therapy Fax Referral
Coram's Infusion Therapy Fax Referral form can be downloaded and faxed to Coram's Centralized Intake line M-F from 6:30am – 4:00pm MST. For immediate and after-hours assistance, please call our national referral line at 800.423.1411.

Fax Referral Download Infusion Therapy Fax Referral Form

CoramRx Fax Referral
For the CoramRx Pharmacy Services Fax Referral form, please visit www.coramrx.com

Hemophilia Services
For Coram Hemophilia Services referral forms, please visit www.coramhemophilia.com

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Online Referral Services

Coram's Online Referral Form
For quick, accurate and secure referral submissions, click here. Upon submission, you will be issued a referral reference code. A Coram admissions representative will contact you within 60 minutes during the business hours of M-F, 7:00am – 7:00pm (CST). If your referral is submitted after business hours, you will be contacted on the next business day. For immediate and after-hours assistance, please call our national referral line at 800.423.1411.

Extended Care Information Network (ECIN)
ECIN is a popular internet referral website used by many healthcare institutions across the country. Coram has many locations which participate in the ECIN network*.

*Please note that Coram does not endorse, warrant, or maintain this site. We offer it to our viewers as a convenience only.

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How to be Referred to Coram
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 80 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 at 800.423.1411 to be automatically directed to a local admissions professional.

There will be a few questions that will be asked in order to determine if Coram’s services can meet your needs both clinically and economically. Having the following items at hand will help to expedite the setup or transfer of your service to Coram:

  1. Name of patient
  2. Name of insured
  3. Patient address
  4. Diagnosis
  5. Therapy required
  6. Prescribing physician’s name
  7. Health Insurance Card or name of insurance carrier

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