Order Form

REGEN-COV (casirivimab/imdevimab)

REGEN-COV is a monoclonal antibody treatment for coronavirus disease 2019 (COVID-19). Casirivimab and imdevimab are the investigational medicines used to treat mild to moderate symptoms of COVID-19 in non-hospitalized adults and adolescents (12 years of age and older who weigh at least 88 pounds (40 kg)), and who are at high risk for developing severe COVID-19 symptoms or the need for hospitalization.

Casirivimab and imdevimab are investigational because they are still being studied. There is limited information known about the safety and effectiveness of using casirivimab and imdevimab to treat people with COVID-19. The FDA has authorized the emergency use of casirivimab and imdevimab for the treatment of COVID-19 under an Emergency Use Authorization (EUA).

REGEN-COV must be administered within 10 days of symptom onset and as soon as possible after receiving a positive SARS-COV-2 test. 
If you meet any of the criteria below, you are unable to receive this therapy:
  • Hospitalized for COVID-19
  • Age <12
  • Weight <40kg
  • Requiring oxygen for COVID-19
    (or increased oxygen requirements due to COVID in a patient who already received oxygen therapy)

For more information, please refer to the Patient Fact Sheet or Provider Fact Sheet.

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 (616) 818-4484.

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

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

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