Referring Your Patient is Easy
Refer your 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.
For patients residing in Alabama please click here.Bleeding Disorder Form
Eculizumab (Soliris®) Form
HyQvia® Form
Infliximab (Inflectra®, Remicade®, Renflexis®) / Golimumab (Simponi Aria®) Form
IVIG Form
Plasminogen (Ryplazim®) Form
SCIG Form
Stelara® (ustekinumab) Form
Tetrabenazine Form
VTAMA® Form
YCANTH™ (cantharidin) Topical Solution 0.7% Form
Other Forms
Questions
Talk with us today about referring a patient. Call us at (800) 323-6832 or send an email to nxinfo@nufactor.com and we will be more than happy to help you through the process.
The information provided on this website is not medical advice, nor is it intended to be a substitute for medical advice, diagnosis, and treatment. Always seek the advice of a physician or other qualified health provider with questions concerning a medical condition. Never disregard professional medical advice, or delay seeking it based on information provided on this website.
