KERYX PATIENT PLUS FORMS

Enroll today to get the full benefits of the Keryx Patient Plus programs

 

Keryx Patient Plus Application

Fill out this comprehensive application with the help of your patient to get enrolled for Reimbursement Help and Patient Assistance.

 

To get started, you and your patient will need to fill out this application, then submit it:

 

Once enrollment has been confirmed, you’ll get full access to a dedicated Keryx Case Manager, your personalized contact to help with any questions you have about our services or benefits.

Download Application

 

Copay Coupon

Download and print AURYXIA® (ferric citrate) coupons for your commercially insured patients. By bringing this coupon to a pharmacy with their prescription, eligible patients pay as little as $0 per fill.

Download Coupon