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InfuseAble Care is now FlexCare Infusion Centers! Arizona patients and providers may continue to access referral forms via the Flexcare website.

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Submit a Referral

Email: orders@flexcareinfusion.com
Fax: (888) 219-8102

Download our convenient fillable PDF referral forms for a specific condition or medication below, then simply fax or email to our office along with the necessary patient documentation. We’ll take care of verifying the patient’s insurance coverage and working through the prior authorization process if needed.

Referral Forms | Infusion Protocols

Click on the name of the drug or condition below to download the PDF referral form. Use the search bar to search our list of referral forms.
Drug Specific Forms | Condition Forms | Pharmacy Forms

Search for forms by drug name

Search for forms by condition

Search Specialty Pharmacy forms 

FlexCare Infusion Protocol

Please click on any box below to download the protocol PDF document.

Acute Infusion Reaction & Anaphylaxis Treatment Protocol

Flushing and Locking Protocols

Infliximab (including biosimilars) Dose Rounding Protocol

Need a different form? We’re here to help!

If you would like to see a referral form that is not listed above, please contact us.

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Makenna joined FlexCare in 2021 as the Managing Nurse Practitioner in Birmingham. In 2023, she assumed the role of National Director of Clinical Services. Makenna oversees protocol optimization, patient safety, and clinical procedures.

Makenna holds an MSN and FNP-C certification from Samford University. Previously, Makenna worked as an ENT nurse before earning her certification from the American Academy of Nurse Practitioners (AANP) in 2018.

Makenna is married to Wes, and together they have two cats, Ralphie and Beans. She enjoys going to concerts, trying new restaurants, playing trivia and board games with friends, and has recently taken up skateboarding as a hobby.

Heather joined FlexCare in 2020 and led the development of the Intake team before taking over Revenue Cycle Management in 2022. Heather has 10 years of medical RCM experience in ambulatory, specialty pharmacy, and home infusion. Previously, Heather was the Assistance Director of RCM in Intake for a Specialty Pharmacy and Home Infusion service in Kansas. 

Currently, Heather oversees RCM for FlexCare’s ambulatory infusion services and specialty pharmacy. She lives in Olathe, KS with her husband and two children.

Rebekkah joined FlexCare Infusion Centers in 2019 as a Managing Nurse Practitioner and Specialty Biologics Clinical Reviewer before assuming the role of Director of Patient Access in 2022. Rebekkah heads FlexCare’s industry-leading Intake team and ensures FlexCare patients experience the shortest time to treatment.

Rebekkah graduated from the University of Oklahoma Health Sciences Center where she earned her Master of Science Degree in Nursing with a Family Nurse Practitioner emphasis. She has over 16 years of experience in patient care and is passionate about infusion therapy and best serving our patients.

Rebekkah lives in Oklahoma City with her 3 kids and her dog. When she’s not keeping busy with her kids, you can find her in her craft room.

Matt is an acute care Nurse Practitioner with over a decade of committed service to the patients in his community. Matt joined FlexCare in 2021 as a Managing Nurse Practitioner and led the launch of the first FlexCare location in Alabama before assuming the role of Vice President of Operations in 2023.

Matt received his BSN from Auburn University before earning his MSN from Vanderbilt University. His experience includes Intensive Care, Transplant Medicine, Cardiothoracic Surgery, and Outpatient Care. Prior to joining FlexCare, Matt developed and launched two new service lines for an outpatient cardiology group in Alabama.

Matt and his wife Rachel reside in Birmingham, AL with their two pets, Addie and Jenkins.

Austin joined FlexCare in 2020 as a software consultant before assuming the role of Vice President of Technology in 2021. He led the initiative to build a custom-developed enterprise software solution that supports and enhances FlexCare’s vital Intake team, and later led the projects to create data and reporting systems to support all departments. He oversees FlexCare’s software, data, IT, and communications projects.

Austin graduated from the University of Oklahoma with a degree in mechanical engineering. His focus on electromechanical systems quickly led to a passion for automation and building software and data solutions. After gaining experience as a software and applications engineer, he started a software consulting company and has launched several enterprise web, desktop, and mobile applications.

Austin lives in Oklahoma City with his wife, Skye, and two kids. In his free time, you can find him on the running trail, golf course, or playing games and sports with his family and friends.

Rick’s professional trajectory took him into leadership just 3 years after obtaining his Doctor of Pharmacy (Pharm.D.) from the University of Arizona. His desire to be a business leader in the world of pharmaceuticals and operations drove him to complete two post-graduate residencies in Milwaukee, WI, with a heavy concentration on administration leadership.  Rick was selected to represent the state of Wisconsin in a joint venture with the state of Iowa at the 2007 Young Pharmacy Leaders Conference.  

After a successful launch to his career in Milwaukee, WI, Rick returned to Arizona to be closer to his extended family.  In Arizona, he oversaw all pharmaceutical operations of the hospital-based outpatient clinics at HonorHealth, where he met his future business partner, Mark Kharoufeh.  Rick and Mark co-founded InfuseAble Care in Scottsdale, AZ, in 2020.  When FlexCare acquired InfuseAble Care in 2021, Rick transitioned to EVP of Pharmacy, leading the supply chain and procurement initiatives across the enterprise.  With the recent acquisition of a specialty pharmacy, Rick extended his purview to include oversight of this valuable service line.

Rick currently resides in Scottsdale, AZ with his wife.  His son attends Northern Arizona University in Flagstaff, AZ.

Mark began his journey in healthcare almost 30 years ago as a pediatric oncology nurse at Los Angeles Children’s Hospital. His evolution in healthcare through various clinical, leadership, and executive roles and a passion for customer service led him down a successful path of business operations. In 2012, Mark was a finalist for AZ Business Magazine’s “Healthcare Professional of the Year” for his leadership in an all-inclusive care under one roof ambulatory healthcare service model. Mark obtained his MBA from Grand Canyon University in 2015 and completed the University of Arizona Eller Executive Leadership Program in 2019. 

Mark’s dedication to enhancing access to healthcare and a model that always places the patients and their caregivers at the center of every visit was the impetus for teaming up with Rick Yerondopoulos and establishing InfuseAble Care in November 2020. Through Mark and Rick’s reputation in Arizona for reliable and service-oriented healthcare, InfuseAble Care’s brand quickly became the trusted ambulatory infusion center for physicians to refer their patients to around the state. Mark and Ricks’s goals of scaling InfuseAble Care nationally came to fruition upon meeting Aaron Smith, Callie Turk, and Adam Midkiff of FlexCare and RC Capital and ultimately joined FlexCare Infusion via acquisition in December 2021.

Since uniting with FlexCare to provide a reimagined infusion experience across the country, FlexCare has grown to 30 ambulatory centers across three states.

Mark currently resides in Litchfield Park, AZ with his wife, two sons, daughter, and labradoodle Eevee. 

Adam joined FlexCare in 2023, though he has been involved with the organization from the early stages. He is excited by FlexCare’s mission to provide better access and high-quality care to patients in cost appropriate settings. Prior to joining FlexCare, Adam was a private equity investor with RC Capital, and he helped architect the partnership between FlexCare and RC. Prior to Adam’s experience in healthcare private equity, he was an investment banker in New York City and involved in numerous M&A and capital raising transactions.

Adam currently resides in Cincinnati, OH with his wife and two kids. He serves on the board of the Cincinnati Healthcare Professionals Network, a group of healthcare leaders with a common goal to advance healthcare innovation within the Cincinnati ecosystem. He graduated from the University of Kentucky with a degree in finance. In his spare time, Adam can be found on a soccer field or a golf course.

Jack joined FlexCare in 2023, after most recently serving as CFO and COO of Lighthouse Behavioral Health Solutions in Central Ohio. Lighthouse focuses on improving the lives of those suffering from substance abuse disorder by combining a suite of services in an outpatient setting along with recovery housing. Prior to Lighthouse, Jack had stints in corporate accounting and finance roles at PricewaterhouseCoopers, Omnicare, and Procter & Gamble. Additionally, he embarked on an entrepreneurial journey over the last decade, beginning with a hospitality business that has grown from a single, urban sports bar to 8 bar, restaurant, and brewery locations opened in 10 years. He also opened and sold a boutique fitness studio.

Jack graduated from Miami University with bachelor’s and master’s degrees in accounting. He resides in Cincinnati, OH, where he can often be found on the golf course or trying to stay active by chasing around his young kids with his wife, Anna.