Patient Forms
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.
Enrollment Application for
(aripiprazole) extended-release injectable suspension
Enrollment Application for
(aripiprazole) extended-release injectable suspension
Enrollment Application for REXULTI®
(brexpiprazole) tablets
Enrollment Application for NUEDEXTA®
(dextromethorphan HBr and quinidine sulfate) capsules
Enrollment Application for VOYXACT®
(sibeprenlimab-szsi) injection
Enrollment Application for JYNARQUE®
(tolvaptan) tablets