718-443-4000Fax: 718-443-5000office@primeinfusions.com
Monday - Friday: 9:00AM - 5:00PMCareers

For Providers

Treatment Referrals

Referring a patient to Prime Infusions is simple. Just complete and fax or email the appropriate referral form. Our dedicated care team will take it from there.

Prescription Requirements

Please be advised that infusion order forms do not serve as valid prescriptions and may not be used as a substitute for one. In accordance with New York State law, a valid prescription must be transmitted electronically or faxed using an official New York State prescription format.

Actemra

Medication pageDownload Form

Infliximab biosimilar family — one shared referral form

Avsola

Medication pageDownload Form

Infliximab

Medication pageDownload Form

Remicade

Medication pageDownload Form

Renflexis

Medication pageDownload Form

Benlysta

Medication pageDownload Form

Briumvi

Medication pageDownload Form

Cerezyme

Medication pageDownload Form

Conexxence

Medication pageDownload Form

Cosentyx

Medication pageDownload Form

Entyvio – Initial

Medication pageDownload Form

Entyvio – Maintenance

Medication pageDownload Form

Hizentra

Medication pageDownload Form

Humira

Medication pageDownload Form

Inflectra

Medication pageDownload Form

Injectafer

Medication pageDownload Form

IVIG

Medication pageDownload Form

Kisunla

Medication pageDownload Form

Krystexxa

Medication pageDownload Form

Leqembi

Medication pageDownload Form

Leqvio

Medication pageDownload Form

Ocrevus

Medication pageDownload Form

Ocrevus Zunovo

Medication pageDownload Form

Omvoh

Medication pageDownload Form

Orencia

Medication pageDownload Form

Pemgarda

Medication pageDownload Form

Procrit

Medication pageDownload Form

Rituxan

Medication pageDownload Form

Saphnelo

Medication pageDownload Form

Simponi Aria

Medication pageDownload Form

Skyrizi

Medication pageDownload Form

Stelara

Medication pageDownload Form

Tepezza

Medication pageDownload Form

Tremfya

Medication pageDownload Form

Truxima

Medication pageDownload Form

Tysabri

Medication pageDownload Form

Ultomiris

Medication pageDownload Form

Venofer

Medication pageDownload Form

Vyepti

Medication pageDownload Form

Vyvgart

Medication pageDownload Form

Vyvgart Hytrulo

Medication pageDownload Form

Zoledronic Acid

Medication pageDownload Form

Send Us a Completed Referral

Submit a referral online

Already completed a referral form? Upload it here and our care team will confirm receipt and begin insurance verification. You can still fax to 718-443-5000 or email office@primeinfusions.com if you prefer.

Infusion order forms do not serve as valid prescriptions. A valid prescription must be transmitted electronically or faxed using an official New York State prescription format.

PDF preferred. Up to 4 MB — large photos are compressed automatically.