The following information is helpful when making a referral:

  • Patient name, address, date of birth, telephone number
  • Diagnosis relating to the infusion therapy, prescription, and therapy start date
  • Intravenous access type (if applicable)
  • Physician and insurance information
  • Other services required

Once you've completed the specific referral form below, please fax it to Oso Home Care at 949-660-7138, or submit it directly using the ‘Submit’ button inside the referral form. (upper-right corner)

 Specialty Pharmacy Referral Form

RA Infusion Order Form

Pediatric Remicade Referral Form

GI Infusion Order Form

Factor Therapy Referral Form

Enteral Referral Form

IVIG Referral Form