Hematologist and Physician Referral
  1. PDSA’s home office receives up to 10 or more requests a week for names of doctors that specialize in ITP. We spend a lot of time researching and gathering names of hematologists and/or physicians around the country that specialize in blood disorders and can treat patients with ITP. As we obtain this information to improve our doctor referral data base, we can support more people around the country and in Canada.

    We would greatly appreciate it if you would complete this simple form should you have a hematologist or physician whom you can highly recommend. Please feel free to pass this along to others you feel may have a recommendation as well.

  2. Physician Name
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  3. Nurse Name
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  4. Hospital Affiliation
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  5. Address 1
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  6. Address 2
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  7. City
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  9. Zip Code
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  11. Phone
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  12. E-mail
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  13. Enter any comments
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  14. (*)
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