TEPEZZA (Teprotumumab-trbw)
Order Form


TEPEZZA is a prescription infusion medication to treat thyroid eye disease. The recommended dosage is 10 mg/kg for the initial infusion treatment, followed by 20 mg/kg every three weeks for an additional seven infusions. The first two infusions should be administered for 90 minutes. Subsequent infusions could vary between 60 and 90 minutes, depending on how well you tolerate the medication. You should talk to your doctor to determine the right dosage and length of treatment for your needs.

Please refer to TEPEZZA’s full Prescribing 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?

Customized Care

1. Ask your healthcare provider to fax us a completed order form for your medication, clinical notes, demographics and your insurance card to (833) 957-2188.

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

On Staff Pharmacist

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.