Quick Referral
Referrals can be made quickly and easily using one of the forms below. Once received, an Intake Coordinator will follow up to complete the process. Referral forms may be downloaded, completed, and emailed to info@infusionconnection.com or faxed to (310) 828-3697.
Call our toll-free number at (310) 828-3690 to speak with a Infusion Connection Intake Coordinator.
Referral forms may be downloaded, completed, and faxed to Infusion Connection at (310) 828-3697.
Please note: Faxed prescriptions can only be accepted directly from the prescribing practitioner. If you are self-referring using the Fax Referral Form, a physician’s signature and an original prescription drug order are required.
If the submitted materials contain Protected Health Information (PHI), Infusion Connection will strictly adhere to HIPAA Privacy regulations to ensure confidentiality and compliance.
Allergy/Asthma
Gastroenterology
Hemophilia
Hepatitis C
Immunoglobulin
Iron Infusion
IV Antibiotic
Migraine
Nephrology
Neurology
Osteoporosis
Rheumatology
Prescriptions in Hours
We guarantee a delivery time of 2-4 hours from the time the prescription is received in our office.
Pharmacists Standing By
Our clinical Pharmacists are on call 24 hours a day, 7 days a week. They can be reached day or night at (866) 828-3690.