THIS SECTION IS FOR HEALTHCARE PROFESSIONALS (HCPs) ONLY
Healthcare Professionals can download a paper application here
To help you get started, please view our short video that will walk you through how to apply and what to expect from the process.
Prefer to fax in an application for your patient?
Just follow these 3 simple steps:
1
Download and print the application
2
Collect all required documentation from your patient
3
Fax the application and the documentation to OPAF at
Please note: Faxed applications are processed within 5 business days. If this is a time-sensitive request, please submit an application online.
(aripiprazole) extended-release injectable suspension
(aripiprazole) extended-release injectable suspension
(brexpiprazole) tablets
(dextromethorphan HBr and quinidine sulfate) capsules
(sibeprenlimab-szsi) injection
(tolvaptan) tablets
See GLOBAL FULL PRESCRIBING INFORMATION for NUEDEXTA and VOYXACT.
See U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING for
See MEDICATION GUIDES for
Want to apply online? Use the OPAF Care Connect Prescriber Portal
To help expedite your patient’s application, be sure to include the proper documentation with your application submission, including:
- Proof of income
- Proof of residency
Have any questions?
OPAF Care Connect Benefits
Prefer to apply online on behalf of your patients? Utilize the
OPAF Care Connect Prescriber Portal.
Receive eligbility determination within 2 business days
Use your work space to find your application and more
Email patient eConsent and HCP eSignature for a seamless application process
View your application online
Get up-to-date and timely notifications
Stay informed with email notifications for patient applications and product requests:
- Get updates regarding your application status and determination results
- Receive notifications when it’s time for annual
re-enrollment - Track status of product shipments