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Refer a Patient for Bleeding & Clotting Disorders

Now Taking Physician Referrals

Learn more about patient safety precautions, virtual visit options, and referring physician resources.

Thank you for referring your patient to University of Utah Health. We value our relationship with referring physicians. Please fill out the form below.

Fax applicable records to: 801-213-8180

Office hours: 8 am–5 pm

Referring Provider Information
Office Address
Referring to Information
Would You Like to Request a Specific Provider?
Urgency Rating
Patient Information
Name
Gender
Address