We put together this tool for healthcare providers to streamline referrals to the C-TRACT Study.  We are dedicated to helping patients with Post-Thrombotic Syndrome (PTS) and are ready to work with you and your patients.

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Do not enter identifiable patient information into this form!

Health Provider Referral Form

Contact information of health care team member (do NOT enter patient name or information here):

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Please notify your team of the study referral so they can expect a call or e-mail from the C-TRACT Clinical Coordinating Center.

Click here to download the C-TRACT referral app to your mobile device.