Refer a Patient

Sample Referral Layout

Jan 6, 2023

×

Actemra®

Step 1

Review our Referral Checklist.

Download Checklist

Step 2

Complete the therapy-specific Order Form.

Fill Online

–or–

Download Order Form

Step 3

Include Supporting Clinicals

Review Clinicals

Completed order forms and supporting clinicals can be faxed to 1-855-healix2 (543.2592) [FPO} or uploaded {link or embed FORMSTACK Healix Site TBD} to our secured portal.