Supply Request Forms

As part of ensuring safe and seamless care for our long-term/chronic patients who receive specialty infusions (i.e., IVIG, Remicade, etc.), it is essential that supply request forms are completed and submitted with your visit note for each patient prior to their next infusion. These forms allow the Pharmacy team to be fully aware of what supplies are needed in advance, which helps to:

• Prevent delays in treatment

• Ensure the correct supplies are available on time

• Support accurate inventory management

• Provide the highest quality care without interruption

Please take inventory and fill out the supply request form while at your visit as soon as you identify the patient’s ongoing needs. Submitting these requests after each visit gives the Pharmacy adequate time to prepare and avoid any last-minute shortages. Supply request forms are not typically required for short term/acute care patients (i.e. Abx, TPN, and/or line care), as these patients are generally on an automatic weekly delivery schedule.

We recognize that even when you complete the forms, there may still be occasional misses from the Pharmacy. However, we must ensure we are doing our part by submitting accurate and timely requests so that any issues that do arise can be addressed.

Thank you for your continued commitment to our/your patients and for helping us maintain the highest standards of care.

Sincerely,

Shari Blackmon, RN-C, BSN

Director of Nursing