Patient Referral

Refer a Patient and we'll Guide Them Through the Insurance Process and Drug Administration.

Need Patient Referral Form?

click here

» Patient Referral Form

Start referring patients immediately by filling out our Patient Referral Form and fax it back to us.

There are four ways get in touch with RX Biotech - Telephone, FAX, E-Mail, or Online.

  • Telephone:

    (310) 657-2881, (800) 657-2212
  • Fax:

    Click here to fill out, sign our patient referral form, and fax it to (310) 657-0906
  • E-mail:

    Email info@RXBiotech.com (or you can email us the Patient Referral Form after filling out & sign)
  • Online:

    Please take a moment to complete the Patient Referral Form. Rest assured that this information will be kept confidential.