Iron Infusion GP Referral

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Doctor Referral Forms

Are you a GP requiring an iron infusion for one of your patients?

We can provide this service for you – usually on the same day. Please fill out our encrypted e-form for your convenience.

Patients cannot be treated (and will be turned away) if all required paperwork is not provided prior to the infusion.

Regardless of your choice to use The Dripclub’s DocuSign form or provide your own letter, please ensure the following points are completed:

  • Referral letter contains:
    • the words “please infuse on my order” or something of that intent
    • provides instruction about the route and administration of medication.
    • a statement that you will remain the supervising doctor in relation to the ongoing care and investigation relating to the treatment of the patient’s iron deficiency
  • Provide your patient with a prescription for ferric carboxymaltose, which they will need to fill and provide to the Dripclub staff prior to infusion.
  • The patient’s name is the same on both the medication and the referral/order.
  • The name of the prescribing practitioner is the same as the referring/ordering practitioner and their registration number and clinic details have been provided on the referral/order.
  • Relevant patient medical history has been provided.

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