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NEW PATIENT REFERRAL FORM Referral Fax Number: (855) 3242799 GenesisCancerBlood. Referral TO GENESIS CANCER AND BLOOD INSTITUTE FOR INFUSED ONCOLOGY DRUGS Please use this form as your cover sheet
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Start by providing your personal information including name, date of birth, and contact information.
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Patients who have been diagnosed with cancer and require specialized treatment.
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Anyone in need of comprehensive oncology services including chemotherapy, radiation therapy, and supportive care.
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Genesis cancer and blood is a report filed by healthcare facilities to track cancer cases and blood transfusions.
All healthcare facilities and providers who diagnose or treat cancer patients or perform blood transfusions are required to file the Genesis cancer and blood report.
The Genesis cancer and blood report can be filled out online through a secure portal provided by the health department.
The purpose of the Genesis cancer and blood report is to track cancer cases and blood transfusions for public health monitoring and research purposes.
Information such as patient demographics, cancer type and stage, treatment received, and blood transfusion details must be reported on the Genesis cancer and blood report.
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