Referral Forms
Infusion/Injectable ReferralHepatitis C Referral
Call us now at
800.734.2896
Online Forms
Infusion/Injectable Referral Form:
With one phone call, fax or email to ICS, we will take care of all of your needs. Our highly trained intake specialists will verify payor source coverage, obtain authorization, and coordinate nursing care. We pride ourselves on seamless care coordination.
CLICK HERE TO DOWNLOAD THE FORM
PHONE 800.734.2896 FAX 559.734.6451
Hepatitis C Referral Form:
CLICK HERE TO DOWNLOAD THE FORM
phone 888.864.0936
fax 888.864.0937
Last Updated Saturday, July 04, 2020 - 11:02 PM.
