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BIOLOGIC MEDICATION

ACTEMRA

Doctor Referral Required

 (For Rheumatoid Arthritis) iv infusion

BENLYSTA

Doctor Referral Required

(For lupus and lupus nephritis) iv infusion

BRIUMVI

Doctor Referral Required

(For Multiple Sclerosis (MS,) iv infusion

CINQAIR

Doctor Referral Required

(For Eosinophilic Asthma) iv infusion

COSENTYX

Doctor Referral Required

For Plaque psoriasis (PsO iv infusion

ENTYVIO

Doctor Referral Required

(For Ulcerative colitis (UC) or Crohn’s disease) iv infusion

HyQvia

Doctor Referral Required

(Immunodeficiency (PI) (CIDP) iv infusion

IV Antibiotics

Doctor Referral Required

(Antibiotics Infusion) iv infusion

IVIG

Doctor Referral Required

(Gamunex-C)(Autoimmune and inflammatory conditions) iv infusion

INFLECTRA

Doctor Referral Required

Injectafer (Iron)

Doctor Referral Required

Intralipid

Doctor Referral Required

Krystexxa

Doctor Referral Required

Leqembi

Doctor Referral Required

Ocrevus

Doctor Referral Required

Onpattro

Doctor Referral Required

Orbactiv

Doctor Referral Required

Orencia

Doctor Referral Required

Remicade

Doctor Referral Required

Renflexis

Doctor Referral Required

Rituxan

Doctor Referral Required

Simponi ARIA

Doctor Referral Required

Soliris

Doctor Referral Required

Solu-Medrol

Doctor Referral Required

Stelara

Doctor Referral Required

Tepezza

Doctor Referral Required

Tezspire

Doctor Referral Required

Tysabri

Doctor Referral Required

Uplizna

Doctor Referral Required

Venofer (Iron)

Doctor Referral Required

Vyepti

Doctor Referral Required

Zinplava

Doctor Referral Required

Zoledronic Acid

Doctor Referral Required

INJECTIONS

Apretude

Doctor Referral Required

Cabenuva

Doctor Referral Required

Cimzia

Doctor Referral Required

Dalvance

Doctor Referral Required

Evenity

Doctor Referral Required

Fasenra

Doctor Referral Required

Ilaris

Doctor Referral Required

Ilumya

Doctor Referral Required

Leqvio

Doctor Referral Required

Nucala

Doctor Referral Required

Prolia

Doctor Referral Required

Skyrizi

Doctor Referral Required

Xolair

Doctor Referral Required

REFER A PATIENT TODAY!

Medication Referral Forms

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