Refer a patient in under a minute. Choose the form that matches your patient’s condition, complete it, and fax or email it to us. We’ll handle benefits verification, prior authorization, patient education, and reporting back to you.
Referral Forms
Jump to your specialty:
Don’t see your specialty? Use the Standard form, or call us at (888) 963-6544 and we’ll get the right paperwork to you.
Where to Send Completed Forms
Fax: (858) 281-0045 | Email: Pharmacy@CureStatRx.com | E-Prescribe: Surescripts
We’ll confirm receipt within one business day and follow up with benefits verification and any prior-authorization questions.
What Happens After You Refer
We handle the parts of the process you don’t have time for: insurance benefits verification, prior authorization, copay and patient-assistance enrollment, patient education before first dose, infusion scheduling, and clinical follow-up. You’ll get a confirmation when your patient’s medication is dispensed and a clinical report after each infusion. Your patient stays yours. We handle everything in between.
INJECTABLE & INFUSIBLE MEDICATIONS OFFERED THROUGH
(858) 281-0045
Main number works for all.