Referral Forms

We help individuals with chronic conditions live a healthier life. From intake through delivery and beyond, we provide the medication, resources, and support making a difference for those we serve.

Step 1: Submission of Intake Information

Patient intake is handled by our therapeutically focused “Centers of Excellence (COE).” Each COE centralizes clinical and administrative expertise for every therapeutic category, allowing us to provide every patient a focused, high level of service and timely access to care.

Step 2: Patient Contact

After receiving the referral, a BioMatrix team member will contact the patient to answer any questions, assist with financial or insurance arrangements, and schedule medication delivery or appointment of in-home services, if required.

Step 3: Dispense and Follow Up

Our pharmacy offers a comprehensive line of specialty medication shipped directly to the patient’s door with standard 24-hour delivery and emergency shipments available. Our clinical team works with each patient to develop a personalized care plan focused on improving health and minimizing side effects.
 

Download A Referral Form:

Please fax completed Bleeding Disorders referral forms to:

(888) 385-2805


Neurology, Immunology, Transplant 

Please fax completed Neurology, Immunology, Transplant referral forms to:

(877) 567-8089


Please fax completed Specialty referral forms to:

(610) 545-6030

 

Please fax completed Fertility referral forms to:

(201) 444-5792