Send a Referral

How to place a referral

It’s quick and easy to place a referral. Submit the form on this page, or simply call a patient care manager at 1-866-696-8143 and provide the following patient information:

Referral Facility Name (required)

Referral Contact Name (required)

Your Email (required)

Contact Phone (required)


Therapy/Orders: (General Information on your Referral)

Attach Orders, Patient Information and History & Physical

You’ll then need to submit the prescribing healthcare provider’s name and prescription or orders. To help make the process even more efficient, provide past clinical notes or a letter of medical necessity upfront, if possible. When the complete information is submitted, we will verify the patient’s benefits, obtain pre-authorization if necessary, and set the patient up with services.

When you refer eligible patients to IVMS for infusion therapy, you become part of the team. Visit our Healthcare Providers page for more information. We look forward to working closely with you to provide integrated, consistent care!