• For reimbursement support, contact R-Pharm US Access and Support in one of the following ways:
  • Call the Support Center at 1-855-991-7277, 8 AM to 8 PM ET, Monday through Friday
  • Fax the Support Center at 1-877-541-7813
  • Download and complete the forms as directed below:
  • R-Pharm US Access and Support enrollment form

    Enroll in R-Pharm US Access and Support by completing this form with your doctor or nurse. Be sure to sign this form. If not signed, you must complete the patient authorization form below.

  • R-Pharm US Access and Support patient authorization form

    If you did not sign the enrollment form above, complete this form to allow R-Pharm US Access and Support to provide services.

The information provided is intended for use by individuals involved with reimbursement support.

The accurate completion of reimbursement or coverage-related documentation is the responsibility of the healthcare provider and patient. R-Pharm US and its agents make no guarantee regarding reimbursement for any service or item. The R-Pharm US Access and Support logo is a trademark of R-Pharm US Operating LLC, a wholly owned subsidiary of R-Pharm US LLC.
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