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Referral forms

Send us the referral, we’ll take care of everything else.

Download the FlexCare fillable referral form, then fax, email or upload your form to send to our team. Registered portal users can log in and submit their referral form. We verify insurance and handle prior authorization.

General referral forms

FlexCare administers FDA-approved medications to treat the following conditions and more:

General

Protocols forms

Patients can experience the FlexCare difference from the comfort of their home. FlexCare Home Infusion provides in-home infusion therapy treatment for patients with rare, chronic and complex conditions. 

Acute infusion reaction and anaphylaxis

Flushing and locking

Infliximab (w/biosimiliars) dose rounding

Iron substitution protocol

Need a different form that's not listed?

We can help. Contact a FlexCare team member.

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