Bleeding Disorder Referrals and Consultations

Physician-to-Physician Consultations

We offer physician-to-physician consultations to discuss complex cases or treatment strategies. To speak with one of our hematologists, please call 206-614-1200.

When to Refer

Consider referring your patients to WACBD for:

Confirmed or suspected hemophilia or von Willebrand disease
Acquired bleeding disorders
Rare clotting factor deficiencies
Inherited platelet disorders
Unexplained bleeding tendencies
Women with heavy menstrual bleeding that may indicate an underlying bleeding disorder
Patients requiring specialized management of bleeding disorders during surgery or other medical procedures

Refer a Patient

Fax WACBD referral sheet, provider notes, and labs to 206-614-1178.

Patient Name *

Date of Birth

Referral Urgency *

Routine

Urgent (Requires provider to call WACBD)

Upcoming Procedures / Surgeries

Referral Type

Consultation

Transfer of Care

Specific Reasons for Referral (Include Diagnosis if Known)

Required Documents

Facesheet- demographics, contact info, preferred language, insurance

Most recent and pertinent clinic notes, including hematology records if previously evaluated

Most recent and pertinent lab results (please include results from tests drawn day of referral)

Referring Provider Name

Institution / Clinic

Provider Phone

Provider Fax

Attach File(s)

Download & Fax

If you’d prefer to print out the form and fax it to us, please download the PDF below and fax the completed form and required documents to 206-614-1178.

Download PDF

For More Information

Schedule a Center Tour

24-Hour Triage & Consultation

If this is a medical emergency, please dial 911. For urgent bleeding concerns outside of regular business hours, call: (206) 614-1200

[For non-emergency inquiries during business hours, please call (206) 614-1200]

206.614.1200