Xywav Patient Enrollment Form. Submit the completed and signed front page of the xywav prescription form to the certified pharmacy by either:. More information about the rems can be found at www.xywavxyremrems.com.
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Web prescriber and patient enrollment is required and available to be completed online. Web form available online at www.xywavxyremrems.com. Web the online rems patient enrollment form can be found here. Web all patients must be enrolled in the xywav and xyrem rems to receive xywav. Submit the completed and signed front page of the xywav prescription form to the certified pharmacy by either:. More information about the rems can be found at www.xywavxyremrems.com. Complete and submit form online at www.xywavxyremrems.com, or scan. Web xywav and xyrem rems patient enrollment form. Fax to xywav and xyrem rems: Xywav and xyrem prescription forms are available for download, but must be printed, signed.
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