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Infusion services orders

Infusion clinic with chairs and cubicles.

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

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