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.
- ACTEMRA® (Tocilizumab)
- BENLYSTA (BELIMUMAB)
- Anaphylaxis Kit
- Cimzia® (certolizumab)
- Entyvio® (vedolizumab)
- Formulario de prescripción de farmacia para infusión en el hogar
- Home Infusion Pharmacy Prescriber Standing Order Form
- Infliximab (Remicade®, Inflectra®, Renflexis®)
- Omvoh™ (MIRIKIZUMAB)
- Orencia®(abtacept)
- Rituximab (Rituxan®, Truxima®)
- Saphnelo® (ANIFROLUMAB)
- Simponi Aria® (golimumab)
- Skyrizi (risankizumab-rzaa)
- Stelara® (ustenkinumab)
- Tremfya® (GUSELKUMAB)
- Amondys 45® (Casimersen)
- Briumvi™ (UBLITUXIMAB-XIIY)
- Efgartigimod (Vyvgart & Vyvgart-Hytrulo)
- EVENITY (Romosozumab)
- Exondys 51® (eteplirsen)
- Formulario de prescripción de farmacia para infusión en el hogar
- Home Infusion Pharmacy Prescriber Standing Order Form
- Anaphylaxis Kit
- Nulojix®(BELATACEPT)
- Ocrevus® (ocrelizumab)
- Prolia® and Xgeva® (DENOSUMAB)
- Radicava® (edaravone)
- Soliris® (eculizumab)
- Tysabri® (natalizumab)
- Uplizna® (inebilizumab-cdon)
- Viltepso® (vitolarsen)
- Vyepti® (Eptinezumab-jjmr)
- Vyondys 53® (golodirsen)
- Inhibidor de la Proteinasa Alfa-1 (Aralast® NP, Glassia®, Zemaira®)
- APRETUDE NURSING ORDER FORM
- Apretude® (cabotegravir)
- Berinert® (C1 esterase inhibitor)
- Blincyto® (blinatumomab)
- Cabenuva® (cabotegravir-rilpivirine)
- Cinryze® (inhibidor de C1 esterasa)
- Gaucher’s Disease – Enzyme Replacement
- General Enzyme Replacement Prescriber Order Form
- Generic Order Form
- Genetic Testing Prescriber Order Form
- Formulario de prescripción de farmacia para infusión en el hogar
- Home Infusion Pharmacy Prescriber Standing Order Form
- Imfinzi® (durvalumab)
- IV Iron Only Prescriber Order Form
- Kalbitor® (ecallantide)
- Kanuma®
- Keytruda® (Pembrolizumab)
- Krystexxa® (pegloticasa)
- KYPROLIS® (CARFILZOMIB) Prescriber Order Form
- Meningococcal Vaccination to Initiate
- Opdivo® (nivolumab)
- Post-Acute Prescriber Order Form
- RECLAST (zoledronic acid) Prescriber Order Form
- REGEN-COVTM (CASIRIVIMAB-IMDEVIMAB)
- Sarclisa (Isatuximab-irfc) Prescriber Order Form
- Severe Asthma Prescriber Order Form
- 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.