Zoledronic Acid (Generic form of Reclast)

For referring providers

Please include the following with your referral:

• Normal calcium within 6 months of referral
• Serum creatinine within 6 months of referral
• Calculated creatinine clearance MUST be greater than 30 mL/min using the Cockcroft-gault equation
• Demographics
• Labs & Tests Supporting Diagnoses

Submit an e-referral →Download the PDF form