Alabama Patient Referral Forms
Refer a patient today and our admissions staff will ensure your patient has all the forms and information needed to onboard with Nufactor. Our process is easy and seamless. Download and submit your completed form by faxing it to (855) 270-7347.
Infliximab (Inflectra®, Remicade®, Renflexis®) / Golimumab (Simponi Aria®) Form
Eculizumab (Soliris®) Form
Bleeding Disorder Form
Plasminogen (Ryplazim®) Form
Talk with us today about referring a patient. Call us at (800) 323-6832 or send an email to email@example.com and we will be more than happy to help you through the process.