Xyrem Patient Enrollment Form

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Xyrem Patient Enrollment Form. If you meet certain financial criteria, such as having a low. Learn select to get your patients started on xywav.

Web dispense xyrem only to patients enrolled in the xyrem rems program pursuant to a valid prescription written by a prescriber enrolled in the xyrem rems program (see. Enroll the patient by completing and submitting the patient enrollment form to the rems. Ad (calcium, magnesium, potassium & sodium oxybates). Learn select to get your patients started on xywav. Enrollment in the rems by prescribers and patients is required by the fda to ensure the benefits of xyrem. Save or instantly send your ready documents. Submit the completed and signed front page of the xywav prescription form to the certified pharmacy by either:. Web provide new patients with a xyrem rems program patient quick start guide. Web complete enrollment form online with us legal forms. See prescribing info and boxed warning.

Download the xywav medication guide and learn more about xywav today. Web the online rems patient enrollment form can be found here. Web specifically, the switch system in the generic sodium oxybate rems ensures coordination among pharmacies such that a drug is dispensed only after there is verification that the. Web prescribers and patients must enroll in the program. All prescribers must be enrolled in to xywav and xyrem rems till prescriptions xywav. The xywav and xyrem rems was developed with the fda to help make sure that xyrem is. Enroll the patient by completing and submitting the patient enrollment form to the rems. Web their caregivers, or xyrem brochure for pediatric patients and their caregivers. Web a special program called rems for xywav and xyrem. Web you must be enrolled in the xywav and xyrem rems to receive xyrem. Web dispense xyrem only to patients enrolled in the xyrem rems program pursuant to a valid prescription written by a prescriber enrolled in the xyrem rems program (see.