You have successfully initiated your Patient Enrollment Form processing. The remainder of the process will be completed via email through DocuSign.
Remind your patient to check their email for a message from DocuSign to complete the enrollment process. When the Patient has signed the form, the Prescriber will receive an email from DocuSign for completion.
Please do not re-submit this…
1 Prescriber Certification
To become certified, each prescriber must complete a XYWAV and XYREM REMS Prescriber Enrollment Form once and submit it to the XYWAV and XYREM REMS via one of the options below. Before enrolling in the XYWAV and XYREM REMS, ensure you’re familiar by reviewing the resources here:…
You have successfully submitted your Prescriber Enrollment Form for processing.
Please do not re-submit this form. The XYWAV and XYREM REMS will contact you when your form has been processed.
3 Prescribe XYWAV & XYREM
To prescribe XYWAV and XYREM, the prescriber must be certified and the patient enrolled in the XYWAV and XYREM REMS.
OPTION 1
Submit Electronic Prescription FormsTo submit the XYWAV or XYREM Prescription Form online for your patient, select the…
What You Should Know
The XYWAV and XYREMS REMS requires that:
All patients must be enrolled in the XYWAV and XYREM REMS by the patient's healthcare provider.Each pediatric patient must have a caregiver who is counseled by the healthcare provider.Prescriptions for XYWAV and XYREM are only dispensed and shipped to patients who are enrolled in the REMS with documentation of safe use…