How to refer
1
Download the order form
Choose the form for the therapy you're prescribing from the list below.
2
Complete & sign
Include patient demographics, insurance information, and supporting clinical notes, labs, and test results.
3
Fax it to us
Fax new referral orders to 971-484-4950 or email intake@vitalcareofportland.com. We handle prior authorization from there.
Order forms
General Infusion Referral
Physician order form for any infusion therapy · PDF
Immunoglobulin (IVIG / SCIG)
Immunoglobulin order form · PDF
GI Order Form
Biologic infusions for Crohn's, UC, and other GI conditions · PDF
Neurology Order Form
Infusion therapies for MS and other neurologic conditions · PDF
Rheumatology IV Medication
IV biologics for RA and related conditions · PDF
Asthma & Allergy
Biologics for severe asthma and allergic conditions · PDF
Alpha-1 Proteinase Inhibitor
Include Alpha-1 deficiency labs and clinical notes · PDF
Fabrazyme Orders
Enzyme replacement therapy for Fabry disease · PDF
Need a form for a therapy not listed here? Use the General Infusion form or call 971-484-4940.
Insurance & prior authorization
We verify benefits and initiate prior authorization for every referral, including future refills, so your office doesn't have to. We work with Medicare, major medical plans like UnitedHealthcare, Aetna, Cigna, Humana, BCBS, and PacificSource, some Oregon Medicaid CCOs, and major pharmacy plans like Express Scripts, OptumRx, and CVS Caremark. We communicate costs upfront so your patient can move forward with confidence.
How to Contact our Intake Team
Phone 971-484-4940
Fax (new referrals) 971-484-4950
9200 SE 91st Ave, Suite 220
Happy Valley, OR 97086
Happy Valley, OR 97086