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YOUR PARTNER IN
INFUSION CARE

Biologic Compounds

PROVIDER FORMS

Healthcare providers may download and complete the Advanced Wellness Infusion Center forms provided below. Once completed, please fax the referral to 352-530-2476 or upload it using the button below and send them to us.

For any questions or assistance, please email us at: nicole@awinfusioncenter.com

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WE MAKE REFERRING
PATIENTS
EASY

Our referral process is simple and streamlined. We take care of therapy orders, insurance authorization, and patient scheduling—so you don’t have to. For every patient, we explore financial assistance options and keep you informed once insurance eligibility is confirmed. Our team also ensures that clinical documentation is timely, thorough, and accurate at every step.

ABOUT

Our infusion centers are dedicated to offering personalized treatments with compassion, supporting every patient along their health journey.

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QUICK LINKS

CONTACT

616 N Palmetto Street Leesburg, FL 34748

(Home Office)

352-702-0850 - Leesburg

904-322-8625 - Clermont

352-353-0055 - Ocala

352-415-3184 - Gainesville

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352-530-2476 - Fax

© 2025 by Advanced Wellness Infusion Centers

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