HOW TO SUCCESSFULLY START PATIENTS ON THEIR TREATMENT JOURNEY

The TAKHZYRO Start Form requires:

• Patient name and contact details: Include the patient's full contact information, including email address and phone number. Also include your patient’s full name at the top of each page where indicated
• Prescriber signature: Review and consent to the prescriber certifications
• Dosage check box: Select 1 starting dosage for new patients
• OnePath enrollment: Remind your patient to check this box to enroll in OnePath and receive product support services such as one-on-one support with a Patient Support Manager (PSM), free injection training, and financial assistance
• Patient signature: Your patient needs to review and consent to the patient authorization, which is critical for allowing OnePath to begin a benefits investigation without delay.

Important guidance when completing the Quick Start Form:

• Ensure your patient's Starting Dosage corresponds to the dosage selected in Section 4 of the TAKHZYRO Start Form
• The prescriber's signature is required. Stamps are not acceptable

*Patients on Medicare or Medicaid are not eligible for the Quick Start Program; please have your patient contact their OnePath representative to discuss other options that may be available to them.

Let your patient know what to expect next:

• If your patient consented to OnePath Product Support, let them know that a dedicated support specialist will call them within 2 to 4 days. Ask your patient to answer the call and save the OnePath number (1-866-888-0660) to their phone to avoid spam blockers
• Additional HAE resources are available for patients to download
• To help your patient understand next steps, provide them with the Getting Started with TAKHZYRO Brochure

The TAKHZYRO Start Form requires:

If a PA is denied, you can use these templates to help during the appeals process. OnePath can also answer questions your office has about the denials and appeals process.