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CIGNA Specialty Pharmacy Services Fax Order Form Please deliver by Requests received after 4 p.m. CT will begin processing the following business day Order Fax 1. 8ml - J0135 Crohn s Disease Starter Pack SelfInjectable Pen DIRECTIONS QTY 6 pens Inject four 40mg pens all on one day SC initially and then inject two 40mg pens 2 weeks later and then inject two 40mg pens 2 weeks later REFILLS 0 Other Psoriasis Starter Pack Self-Injec.

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