Providers

Why is Evergreen Right for Your Practice?

Managing your patients' complex conditions and therapies can be difficult.


Our interactive practice area, disease state, and medication-specific referral forms make prescribing easy.

Our Team of Patient Care Advocates and Pharmacists are experienced and knowledgeable in both specialty and non-specialty medications, navigating the insurance authorization process, and connecting patients to available financial resources such as patient assistance and grant or foundation support.


In the end, we go the extra mile to fulfill your chosen therapy and help patients succeed in treatment.
 

Referral Forms


Sending a new referral to Evergreen is simple! Download the form, type or print the appropriate information, then fax it to us. We encourage you to e-prescribe to make the process even easier. 


Contact Us for a customized form specific for your office.



This section is for prescribing practitioners only. Patients must bring an original prescription to the pharmacy, and cannot fax these referral forms to Evergreen. Faxed prescriptions will only be accepted from a prescribing practitioner.


Practice Area and Disease State Forms

  • Atopic Dermatitis


  • Behcet's Disease
  • Plaque Psoriasis
  • Psoriasis

Neurology

  • Asthma
  • COPD
  • Idiopathic Fibrosis
  • Pulmonary Arterial Hypertension


Medication-Specific Forms

We Offer a Local Injection Clinic Services

Pharmacists at Evergreen Pharmacy are certified to administer a wide variety of injectable medications including subcutaneous biologic therapies, long-acting antipsychotics, intramuscular addiction therapies, and many more.


Click here to learn more!

We are available by phone

9:00 am - 5:00 pm Monday-Friday

Secure Voicemail is Always Available



Our FAX number for Provider Correspondence is:  414-533-6601 

If you call during business hours and do not get a response please 
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