How to Make a Referral

Referring a patient to Infusion for Health is fast and easy.

Making a patient referral for infusion therapy is simple. To refer a patient, follow these three steps:

Step 1: Download the therapy-specific order form from the list below.

Step 2: Complete the order form.

Step 3: Fax or email the completed order form to (805) 852-2636 or Please make sure you include the patient’s details, including:

  • Full contact information.
  • Insurance information with a front and backside copy of the patient’s insurance card.
  • Diagnosis with supporting documentation.

That’s it! After receiving the order form and the patient’s information, we will handle all other details surrounding the patient’s infusion therapy treatment.

While some pre-determination decisions may take longer than others, we do our best to get each treatment approved as soon as possible. We will keep you and your office updated on the patient’s status throughout the insurance approval process.

Infusion/Injection Therapy Order Forms
Please find our therapy-specific forms below. Note that Infusion for Health routinely updates our forms to adhere to new insurance requirements, so be sure to download the latest version. To inquire about a specific therapy not listed below, please contact us or complete the blank order form available here. We can email, fax, or deliver forms directly to your office.

Refer a patient

If you’d like to refer a patient, you can contact us online or call us at (888) 777-1945 to reach a member of our team.

Infusion For Health offers exceptional infusion therapy services in comfortable, convenient, and safe locations throughout the U.S.