Referring your patient to Coram Hemophilia Services is simple and 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 hemophilia referral line 888.699.7440
to be connected to your local Coram branch. Local branch information is also available on our Branch Location Finder.
Online Referrals
Use our quick, accurate, and secure Online Referral Form![]()
Fax Referrals*
Review and download our Factor Therapy Fax Referral Form![]()
*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.


