Refer a Patient

At Karmanos, we are grateful to serve our region and consider it a privilege to earn your trust when a referral to an NCI-designated comprehensive cancer center is needed. Patients will be offered the best possible outcome by having access to 16 locations, 250+ cancer treatment options, access to an extensive clinical trials portfolio and collaboration with you, the partner.

One of our main goals is to make referring your patients as easy as possible. With the help of Karmanos’ Referring Physician Office (RPO) provides direct and efficient concierge services to referring partners.

Referral Options

As a physician, you can refer your patients to see our specialists for cancer treatment, or you can refer your patients to rule out a potential cancer diagnosis.

• Online: Fill out our quick and easy online form.
  Online Referral Form
• Fax: Download, complete and fax the form to 313-576-9827.
  Download a Referral Form
• Phone: Call our referring physician line to speak with a Karmanos representative.
Call 1-877-KARMANOS


Having the following information available when you speak to a Karmanos representative will make the process quicker and more convenient for you.

What You Will Need for a ReferralFrequently Asked Questions

1. Patient Information

• Patient’s full name
• Patient address (street, city, state, zip)
• Day, evening and emergency telephone numbers
• Complete insurance information

2. Referring Physician Information

• Name
• Address
• Phone
• Primary care physician name, address and phone (if different)

3. Information Needed for Appointment

The patient should bring complete medical records including:

• Original films
• Slides
• Copies of reports of any mammograms, ultrasounds, biopsies, other relevant tests or medical history.

We appreciate your help in securing these.

View All

Referral Form Based on Appointment Request

Please download and fax to us the form pertinent to the type of appointment request, as well as the Authorization to Request Medical Records form.

• New Patient Referral Form
  • This form is needed for any patient who requires a consultation with our oncologists.
• Authorization to Release Medical Information Form
  • Download and have your patient complete this form to expedite the process of acquiring medical records for use by our staff and oncologists

You can also access our online Provider Directory for more information on our physicians, including:

• Phone numbers
• Specialties
• Board certifications
• Research interests
• And more

Outside Physician Imaging/Procedure Order Forms

• Breast Imaging Form
• CT/MRI Order Form
• LDCT Order Form
• PET/CT Order Form

Enroll in the Physician Communication Program

To expedite communication about your patient’s care at Karmanos Cancer Institute, we invite you to enroll in the Karmanos Physician Communication Program. By participating, you will automatically receive updates, ensuring prompt updates on the care of your patient. Please complete the enclosed application and return it to us via electronic mail, postal mail or facsimile, as noted on the application. The security of patient health information is paramount. After we receive your application, we will send a test message to verify your enrollment. For more information, please read our Enrollment letter.

Physician Communication Enrollment Form