Referring a patient
is as easy as 1-2-3
Referring a patient is simple – select the therapy and product below to access the correct prescriber order form. Then, just follow three steps:
Download
Select a product from the list below and download the product order form.
Fill, Print & Sign
Complete the form on line or by hand, then print and sign the completed prescription.
Fax
Fax signed forms to the Option Care Health location most convenient for your patient.
Find Location
If the required therapy is not listed, please call us at 877-686-2622 or electronically prescribe the medication.
- Противоинфекционная терапия
- Нутритивная поддержка
- Хронические воспалительные процессы
-
- ACTEMRA® (Tocilizumab)
- BENLYSTA (BELIMUMAB)
- Anaphylaxis Kit
- Cimzia® (certolizumab)
- Entyvio® (vedolizumab)
- Бланк заказа назначенного препарата для проведения процедуры инфузионной терапии на дому
- Home Infusion Pharmacy Prescriber Standing Order Form
- Инфликсимаб (Remicade®, Inflectra®, Renflexis®)
- Orencia®(abtacept)
- Rituximab (Rituxan®, Truxima®)
- Simponi Aria® (голимумаб)
- Skyrizi (risankizumab-rzaa)
- Stelara® (ustenkinumab)
- Иммуноглобулин
- Неврологические расстройства
-
- Amondys 45® (Casimersen)
- Briumvi™ (UBLITUXIMAB-XIIY)
- Efgartigimod (Vyvgart & Vyvgart-Hytrulo)
- Exondys 51® (eteplirsen)
- Бланк заказа назначенного препарата для проведения процедуры инфузионной терапии на дому
- Home Infusion Pharmacy Prescriber Standing Order Form
- Leqembi
- Leqembi – MRI Confirmation
- Anaphylaxis Kit
- Ocrevus® (окрелизумаб)
- Prolia® and Xgeva® (DENOSUMAB)
- Radicava® (edaravone)
- Soliris® (eculizumab)
- Tysabri® (натализумаб)
- Uplizna® (inebilizumab-cdon)
- Viltepso® (vitolarsen)
- Vyepti® (Eptinezumab-jjmr)
- Vyondys 53® (golodirsen)
- Нарушение свертываемости крови
- Женское здоровье
- Сердечная недостаточность
- Специализированная терапия
-
- Ингибитор альфа-1 протеиназы (Aralast® NP, Glassia®, Zemaira®)
- Apretude® (cabotegravir)
- Bavencio® (avelumab)
- Berinert® (C1 esterase inhibitor)
- Blincyto® (blinatumomab)
- Cabenuva® (cabotegravir-rilpivirine)
- Cinryze® (ингибитор С1-эстеразы)
- Бланк заказа назначенного препарата для проведения процедуры инфузионной терапии на дому
- Home Infusion Pharmacy Prescriber Standing Order Form
- Imfinzi® (durvalumab)
- Kalbitor® (ecallantide)
- Kanuma®
- Keytruda® (Pembrolizumab)
- Krystexxa® (пеглотиказа)
- Meningococcal Vaccination to Initiate
- Opdivo® (nivolumab)
- Anaphylaxis Kit
- Tecentriq® (Atezolizumab)
- Tepezza® (teprotumumab-trbw)
- Trogarzo® (ibalizumab)
- Ultomiris® (ravulizumab)
- Vyjuvek™ (BEREMAGENE GEPERPAVEC)
- Yervoy® (ipilimumab)
Have questions about our services?
Have questions about our services? Please call us at 877-686-2622 or submit our Contact Form.
All Option Care Health pharmacies are able to accept electronic prescriptions (e-prescribing).
Prescriptions must be sent from licensed prescribers, accompanied by the patient’s insurance information and in accordance with your state prescribing laws.