Oncology

Corpus Christi
Office: (361) 694-5311
Fax: (361) 808-2069

Rio Grande Valley
Office: (956) 688-1208
Fax: (361) 808-2159

Fax information required by referring physician:

• DCH Patient Referral Form (Script signed by PCP)
• Patient and guarantor demographics (Phone, DOB, SSN, address, etc.)
• Insurance/Medicaid card (Front & Back)
• Last history and physical
• Immunization record
• Pertinent lab work, ccans and X-Rays

Patient must bring to appointment:

• Patient must be accompanied by parent/guardian (with ID) who know history
• Immunization card
• Insurance card
• Current medications
• Current medications, frequency and dosages (please include medications that are used only when needed)