Phone....|....678-705-2055
FAX....|....470-428-2094
EMAIL....|....[email protected]
ADDRESS....|....5881 Glenridge Dr, Suite 110, Atlanta, GA 30328
Referral Page
→ IG Order Form
→ Gastroenterology Specialty Infusion
→ Pulmonary Specialty Infusion
→ General Order Form
→ Neurology Specialty Infusion
→ Rheumatology Specialty Infusion
Notes:
The referral form acts as a prescription if one isn’t available. If you have a prescription, please include it to start benefits investigation. Our referral form is required for nursing and anaphylaxis orders but won’t delay benefits investigation and will be obtained from the provider during the process.
To ensure a streamlined process, please email or fax completed referral form WITH the following items:
Progress notes from the last year
Labs
Copy of insurance card front and back
Patient demographics
to [email protected]
or fax to +1 (470) 428-2094
Why?
We can get benefits and the prior authorization started and avoid unnecessary phone calls and delay
Vital Care of Atlanta
We provide IV medications, supplies, and nursing support for patients who need infusion therapy at home - Just send a referral, and we handle the rest!
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