I need to refer a patient for...

Select a referral category

Select a therapy-specific referral form. Each PDF can be printed, completed by your office, and faxed to TheraVite, or completed digitally and emailed to info@theravitehealth.com.

Bleeding Disorders
View form →
Entyvio®
View form →
General Infusion
View form →
General Specialty
View form →
Infliximab (Remicade®)
View form →
IVIg / SCIg
View form →
Ocrevus®
View form →
Rituxan®
View form →
Stelara®
View form →
Skyrizi®
View form →
Tysabri®
View form →
Hereditary Angioedema
View form →

Don’t see your therapy? Use the General Specialty or General Infusion forms above, or contact us at info@theravitehealth.com.

How Referrals Work

From referral to first treatment, in 5 to 10 business days.

1

Submit

Complete and fax or email your referral form

2

Acknowledge

Same-day email confirmation to your office

3

Verify

Benefits and prior auth in 24-48 hours

4

Schedule

Direct contact with patient

5

Update

Communication back to your office

Why TheraVite

A specialty partner that respects your time.

  • Same-day referral acknowledgment
  • 24 to 48 hour benefits investigation
  • Dedicated multidisciplinary care team for every patient
  • Proactive communication to your office
  • Integrated infusion plus specialty pharmacy
Learn About Our Partnership Model
Have Questions?

Are you a provider with questions?

At TheraVite, patient referrals aren’t a handoff — they’re a handshake. Reach out to us with any questions about the referral process, drug access, prior authorization, or insurance coverage for a specific patient.

Contact Us