For our referring primary care physicians:

Thank you for entrusting Amicus with the care of your rheumatology patients. Our goal is to work with you to provide them with a positive, considerate, and efficient experience.

We need to gather some information from you to help us see your patients as soon as possible, including recent chart notes, current tests and radiology reports (such as DXA scans for osteoporosis patients), and authorization information that is needed by some health plans (most commonly for HMOs and IPAs).

Our referrals and authorizations coordinator has a checklist available to help simplify the process for you, your team, and your patients. Please use this checklist to gather and send to us the necessary paperwork before your patient schedules their visit.

To request the checklist, use the form below, and we will email it to you (if you prefer we fax it, please include your number in the message).

(Please note: this form is not secure and should only be used for requesting our checklist/information packet, not for transmitting patient information.)

Your Name

First Name

Last Name

Practice Name (if different)

Email Address

Email Checklist or Fax It?

Tell us how to send your checklist. Include fax number or emails that should receive the documents.