Refer A Patient

Easy Referral Process

Simply complete and fax the appropriate referral form. Our care team will handle the rest, including insurance verifications.

Referral forms for our Specialty Infusion Centers can be found at specialtyinfusion.com/refer-a-patient.

Treatment Referral Forms

Actemra®

Adakveo®

Amvuttra®

Apretude

Aralast®

Avsola®

Benlysta

Boniva®

Briumvi®

Cerezyme®

Cimzia®

Cinqair®

Cinryze®

Crysvita®

Elaprase®

Elelyso®

Entyvio®

Evenity®

Fabrazyme®

Fasenra®

Givlaari®

Glassia

Hydration

Ilaris®

Ilumya®

Infliximab®

Intralipid®

Keytruda®

Krystexxa®

Lemtrada®

Leqembi™

Leqvio®

Loqtorzi™

Lumizyme®

Nexviazyme®

Nucala

Nulojix®

Ocrevus®

Omvoh™

Onpattro®

Opdivo®

Opdivo® with Yervoy

Opdualag™

Orencia®

Oxlumo®

Prolastin® -C

Qutenza®

Remicade® or Biosimilar

Renflexis®

Rituxan® or Biosimilar

Ruxience®

Rystiggo®

Saphnelo®

Self Pay

Simponi Aria®

Skyrizi®

Soliris®

Solu-Medrol®

Spevigo®

Stelara®

Tecentriq®

Tepezza®

Tezspire®

Thyrogen®

Truxima®

Tysabri®

Ultomiris®

Uplizna®

Vitamin Therapy

Vyepti®

Vyvgart®

Vyvgart® – Hytrulo

Xenpozyme®

Xolair®

Yervoy®

Zemaira®

Zoledronic Acid