Referrals - Infusion Solutions Inc

At Infusion Solutions, we want to make referrals as simple as possible for the entire health care team.

Please choose from our referral forms below and fax the necessary information to us at (360) 933 – 1197 to facilitate a swift and easy referral process.

If you would like us to create a customized order form that would better meet the needs of your practice, please let us know and we would be happy to accommodate that request.

Name	Size
F302 Remicade/Infliximab Order Form	154.8 KiB
F303 - IVIG Physician Order Form	104.1 KiB
F304 - Antibiotic Physician Order Form	34.8 KiB
F306 - TPN Physician Order Form	34.3 KiB
F307 - Zoledronic Acid Physician Order Form	81.0 KiB
F309 - Iron Physician Order Form	82.7 KiB
F310 - Solu-Medrol Order Form	29.3 KiB
F311 - Infusion Solutions Referral Form	179.0 KiB
F313 - Stelara (for Psoriasis) Order Form	78.9 KiB
F313a - Stelara (for Crohn's Or UC) Order Form	120.3 KiB
F318 - PCA Order Form	41.1 KiB
F319 - Octreotide Order Form	30.2 KiB
F324 - IDPN Order Form	80.0 KiB
F325 -Hydration/Hyperemesis Referral Form	184.1 KiB
F334 - Intrathecal Pump Order Form	34.8 KiB
F344 - DHE Referral Form	130.9 KiB
F350 - Ocrevus Physician Order Form	40.6 KiB
F351 - Tysabri Physician Order Form	82.0 KiB
F358 - Entyvio Physician Order Form	82.0 KiB
F396 - Evusheld Order Form With ICD-10 Codes	106.4 KiB