Ambulatory infusion therapy
Kaiser Permanente provides infusion services at seven ambulatory clinics throughout Washington. Many specialty infusion medications require supplemental orders to ensure safe administration of these medications during a nurse visit.
Kaiser Permanente infusion locations
Bellevue Medical Center
Capitol Hill Campus
Everett Medical Center
Olympia Medical Center
Riverfront Medical Center
Silverdale Medical Center
Tacoma Medical Center
Infusion therapy order forms
Contracted specialists must use one of the following forms based on a standardized protocol to order one of these medications for administration at a Kaiser Permanente medical office. These forms were developed based on clinical evidence and best practice recommendations for administering these treatments. These forms are in print-friendly PDF format.
Fax completed order forms to the infusion center where the patient will be receiving treatment.
Lab orders are not included on the infusion therapy request form; place orders via usual method. Lab monitoring is the responsibility of the ordering physician.