Refer a Patient

Please download and fax the form below to refer a patient to CMOH.
Rapid Referral Form

Coordination of Care Agreement

CMOH has developed a comprehensive Coordination of Care Agreement between our practice and referring physicians that is based on the American College of Physicians concept of the specialist functioning as a patient centered medical home neighbor (PCMH-N).
Download Coordination of Care Agreement

CMOH has also modified the treatment intervention careplan during this COVID-19 pandemic:

Download Modified Treatment Intervention Careplan

This agreement specifies that:

  • Pre-referral discussion is available to clarify the extent of care and expedite the delivery of services
  • CMOH will provide timely written communications to referring physicians from the initial consultation throughout the patient journey
  • CMOH will assume responsibility as the primary point of triage and coordinate for any necessary diagnostic testing or referral to other specialists


The Agreement also defines the role of the primary care physician or referring physician:

  • Embrace the philosophy of the Oncology Patient Centered Medical Home
  • Accept the role of CMOH as the primary point of triage
  • Address all chronic and non-oncologic issues
  • Participate in end of life discussion

Our Cancer Treatment Locations

Convenient locations throughout the Greater Philadelphia area including Delaware, Montgomery and Chester Counties.