Columbus Community Hospital

Infusion services

Columbus Community Hospital’s Infusion Center provides services for both children and adults from 8 a.m.-5 p.m., Monday-Friday. The Infusion Center was created for the convenience of patients and families, allowing them to stay close to home for intravenous (IV) and chemotherapy medications, dressing changes or related services.

Infusion orders

  1. Print and complete the Columbus Community Hospital referral form.
  2. Click on the desired infusion order below to download and print the PDF.
  3. Complete all sections, sign both the infusion order and the referral form with ink.
  4. Fax the signed order set, referral form and the documents listed on the referral form to 402-562-4639.
     

HSR Algorithm

Abatacept (ORENCIA)

Albumin Infusion for Paracentesis (BUMINET, FLEXBUMIN)

Belatacept (NULOJIX)

Belimumab (BENLYSTA) Infusion

Benralizumab (FASENRA) Subcutaneous Injection

Blood Transfusion Orders

Certolizumab (CIMZIA) Injection

Cosyntropin (CORTROSYN) Stimulation Test

Darbepoetin Alfa (ARANESP) Injection

Epoetin Alfa-epbx (RETACRIT) Injection

Eptinezumab-jjmr (VYEPTI) Infusion

Ferric Carboxymaltose (Injectafer) Orders

Ferumoxytol (FERAHEME) Infusion

Filgrastim-sndz (ZARXIO) for Stem Cell Mobilization

Hypersensitivity Orders

Immune Globulin (IVIG) Infusion

Inclisiran (LEQVIO) Injection

InFLIXmab (REMICADE) Infusion

Iron Dextran (INFED) Infusion

Iron Sucrose (Venofer) Orders

Natalizumab (TYSABRI) Infusion

Ocrelizumab (OCREVUS) Infusion

Outpatient Infusion Orders (blank)

Pamidronate (AREDIA) Infusion

riTUXmab Infusion

Romosozumab-aqqg (EVENITY) Injection

Teprotumrmab-trbw (TEPEZZ)

Therapeuitic Phlebotomy