For Providers
Referral Forms
Infusion & Injection Therapy Order Forms

Healthcare providers can use the below referral forms to submit a patient order.
Completed order forms and supporting clinical documentation can be faxed to (833) 786-0025 or uploaded to our secured portal. We'll take care of the rest. Questions? Give our team a call at (800) 958-4042. We’re happy to help!
Biologic Referral Forms
Infectious Disease Referral Forms
Wellness & Hydration Referral Forms
To inquire about a specific therapy not listed above, contact us.
Explore More For Providers
Refer a Patient
Healix Infusion Care is the best choice for patients requiring outpatient infusion or injection therapy to manage acute and complex chronic conditions.
Our Approach to Infusion Care
At our centers, we take pride in the quality of care and training that each member has undergone.
Insurance and Coverage Information
As a medical provider, ensuring your patients receive high-quality, continuous care is a primary focus. At Healix Infusion Care, we share this commitment. We work closely with insurance companies to minimize out-of-pocket costs and secure optimal coverage for the...



