Resources

Below is a comprehensive resource list to help you and your patient get access to XYWAV.

  
  
  
  
  
Results Found: 30
Video 1 – Sign Them Up
  • JazzCares Enrollment

Highlights mandatory enrollment in the XYWAV and XYREM REMS and the optional resources available for patients on XYWAV.

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XYWAV and XYREM REMS Prescriber Enrollment Form
  • XYWAV and XYREM REMS

Prescribers must be certified in the XYWAV and XYREM REMS to prescribe XYWAV to their patients by completing and submitting this required, one-time enrollment form.

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XYWAV and XYREM REMS Patient Enrollment Form
  • XYWAV and XYREM REMS
  • Patient-specific

Prescribers enroll their patients in the XYWAV and XYREM REMS by completing and submitting this required, one-time form. Both the prescriber and the patient or caregiver are required to sign this form.

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XYWAV Prescription Form
  • XYWAV and XYREM REMS

Once the prescriber is certified and the patient is enrolled in the XYWAV and XYREM REMS, the prescriber completes and submits this form so the patient can receive XYWAV.

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JazzCares Patient Authorization Form – English
  • JazzCares Enrollment
  • Patient-specific

It is highly recommended that your patients enroll in JazzCares to access nursing and pharmacy support, financial assistance programs, and resources available throughout their treatment journey.

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JazzCares Patient Authorization Form – Spanish
  • JazzCares Enrollment
  • Patient-specific

It is highly recommended that your patients enroll in JazzCares to access nursing and pharmacy support, financial assistance programs, and resources available throughout their treatment journey.

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Guidance for Patient Authorization Form
  • JazzCares Enrollment

Offers guidance to you and your office staff when helping their patients complete the JazzCares Patient Authorization Form.

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JazzCares Suite of Services Flashcard
  • JazzCares Enrollment
  • First Shipment of XYWAV
  • Ongoing Support
  • Insurance and Financial Assistance

Provides a high-level overview of JazzCares programs and services available to support your patients’ needs once they start on XYWAV and throughout their treatment journey.

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REMS=Risk Evaluation and Mitigation Strategy.

Contact Your Jazz Account Representative