|
To Make a Referral...
Thank you for the opportunity to participate in the care of your patient! It is our goal to make the referral process as easy as possible for you. Please select the type of patient that you are referring.
Home Infusion
Specialty Injectable
Ambulatory Infusion Center
... for a HOME INFUSION patient; In order to best serve you and your patient we request that you call an Intake Coordinator directly at 1-800-278-2101 for all Home Infusion referrals. Please be prepaired to provide the patient's demographic information, allergies, diagnosis, medication orders, insurance information and the name of the home health agency that will be seeing the patient. Return to Top of Page
... for a SPECIALTY INJECTABLE patient; For fastest service please download the appropriate Referral/Order form below, complete and sign it, and then fax it back to us. Or, if you prefer, you can call an Intake Coordinator directly at
1-800-278-2101.  Download Specialty Injectable Referral/Orders
Use this form for most Specialty Injectables for RA, MS, Hep C, etc. Download Xolair Referral/Orders Return to Top of Page
... for an AMBULATORY INFUSION CENTER patient; For fastest service please download the appropriate Referral/Order form below, complete and sign it, and then fax it back to us. Or, if you prefer, you can call an Intake Coordinator directly at
1-800-278-2101. Download Tysabri Referral/Orders Download Reclast Referral/Orders Download General AIC Referral/Orders
Use this form for any AIC infusion not listed above, such as
Solu-Medrol, Remicade, etc. Return to Top of Page |
|
NOTE: Not all internet browsers support our download feature. For best results we suggest viewing this page with Internet Explorer, version 6 or higher. Adobe Reader is required to view our downloads. If you need Adobe Reader, click below to download a free copy of the software.
Documents may take a few moments to open depending on your connection speed.
Please be patient. |
|
TheraPoint serves all or portions of the following Pennsylvania counties: Bradford, Carbon, Columbia, Lackawanna, Luzerne, Monroe, Pike, Schuylkill, Sullivan, Susquehanna, Wayne, and Wyoming.
Website maintained by and all content is copyrighted 2008 by Home Infusion of Luzerne County Inc., DBA: TheraPoint
(Formerly DBA optioncare of Dunmore and optioncare of Kingston)
Website designed and powered by remarkablesites.com |
|
|
