Prescribers Forms
PRESCRIBERS
Online Submission
- Fill Form: Complete form via DocuSign.
- Authorize Signature:
- Sign form or
- Select “Finish Later” and enter prescriber’s email to sign remotely.
- Attach Documents: Include necessary documents.
- Submit: Click “Finish” to send.
Email Submission
- Download and Complete: Click “Download form” and fill out.
- Submit via Email: Send form and documents to intake@realinfusions.com.
Fax Submission
- Download and Complete: Click “Download form” and fill out.
- Submit via Fax: Fax form and documents to (347) 533-7000