Infusion Services Orders

/ Infusion Orders

Infusion clinic with chairs and cubicles.

.image.gbi-104586487-obJaMzV9fueNfwumhEYDzX:before { opacity: 1; background-image: url('/static/03a31a76fe9871b8433eae37fab1975b/5d2c5/infusion-services-bay.png'); }

Spectrum Health provides infusion services to patients in 13 counties across West Michigan. Printable, faxable orders are available below, as well as a list of Spectrum Health Outpatient Infusion Clinic locations and fax numbers. Follow these steps to get started:

Print and fill out the infusion onboarding slip completely
Print and complete the paper order form
Ordering provider signature is required on both documents
Fax completed forms to the Spectrum Health Outpatient Infusion Clinic

Ordering/modifying/discontinuing therapy plans

Infusion onboarding slip

Therapeutic phlebotomy consent form

Transfusion of blood or blood products consent form

Infusion order forms

Infusion order forms

A

B

C

D

E

F

G

H

I

L

M

N

O

P

R

T

U

V

W

Z

Our Locations