Begin the Referral Process

To begin a new referral, select the appropriate site of care to access prescriber order forms and fax to your local Care Management Center. For more information on our services, please complete the form below.

Option Care Health delivers a rapid response to referrals and quick turnaround for coverage verification with 24/7 support for providers and patients from specially trained infusion nurses and pharmacists.

An Option Care Health representative will contact you within two business days.

Refer a Patient

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Your First and Last Name

Job Role

Dr. First Name

Dr. Last Name

Dr. Email

Dr. Phone

Job Title

Contact Preference

Services Interested

Patient Name

Patient Date of Birth

Patient ZIP Code

Hospital or Practice Name

No abbreviations, please spell out all words

Hospital or Practice City

Hospital or Practice State

Hospital or Practice Zip Code

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Please complete the form above or call 844.624.4584 for assistance.

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