We are looking forward to assisting you in the care of your patient. Here’s how to get started with a referral:

Please download the form below and complete entirely, paying attention to the highlighted items.
Once the provider has signed the bottom, please fax everything to the number at the top of the form, or email to address at top of the form to begin the referral process.

Please download the form below and complete entirely, paying attention to the highlighted items.
Once the provider has signed the bottom, please fax everything to the number at the top of the form, or email to address at top of the form to begin the referral process.
If the therapy that you are seeking isn’t found here, please visit MD Health Solutions where the patients may receive infusions in one of our private suite locations, or call our intake department directly to request a review.

Gastroenterology

Remicade Biosimilar

Neurology

Rheumatology

Remicade Biosimilar

Rituxan Biosimilar

Other