INFLECTRA® (Infliximab-dyyb)
Order Form

INFLECTRA (infliximab-dyyb)

Inflectra is designed to treat pediatric patients and adults with Crohn’s disease, ulcerative colitis, rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis. Each infusion treatment should only be administered with a medical professional closely monitoring the therapy and scheduling regular follow-up visits.

*Depending on the patient’s health plan, IA may recommend an alternative infliximab.

Please refer to the full prescribing information for more information.

Note: Please speak with your healthcare provider for more information if you think this therapy might be right for you.

How do I make a referral or transition my treatment to Infusion Associates?

1. Ask your healthcare provider to fax us a completed order form for your medication, clinical notes, demographics and your insurance card to (833) 996-4888.

2. Providers can find order forms on our medications page.

3. One of our intake specialists will contact your healthcare provider to confirm receipt of your referral.

4. We will then verify benefits, obtain any required prior authorizations, and contact you to schedule an appointment.