VelsipityForMe for Your Patients

Support resources for patients prescribed Velsipity

Support resources for patients prescribed Velsipity

VelsipityForMe is here to support your VELSIPITY patients throughout their therapy experience.
This program is designed to assist your patients by providing support:

A tracker to view your patient’s progress through their treatment journey and educational resources to inform patients along the way

Insurance assistance: Benefits investigation and assistance with prior authorizations and appeals

Support program assisting with coordination of required baseline assessments

Status tracker showing when their prescription was shipped to the pharmacy

Frequently Asked Questions

Why and when should my patients enroll in VelsipityForMe?

VelsipityForMe provides support throughout the steps of your treatment journey, including the insurance process, reimbursement support and other support offering to assist patients in accessing their prescribed Velsipity. We also offer educational resources to help you prepare for treatment and navigate through the steps.
The physician will need to initiate a patient's enrollment in the VelsipityForMe program.

How do I get access to this VelsipityForMe portal for healthcare providers?

We recommend that healthcare providers who are part of the Pfizer treatment network use this portal for coordination and support of your patients who are pursuing treatment with Velsipity. Please contact your Pfizer representative if you are interested in becoming part of this network, or if you are already in the network and need assistance setting up your account or using this portal.

What kind of information can I find in this VelsipityForMe portal for healthcare providers?

This portal will facilitate information exchange and coordination throughout your patient’s treatment journey. Within the portal you will find:

  • Information about your patient, including the members of their care team and Pfizer support resources
  • Insurance information, including a summary of benefits as well as information related to prior authorizations or appeals requirements, as applicable
  • Updates and notifications related to your patient’s next steps in the journey
  • Information related to prescription ordering and shipment to the pharmacy
Looking for the Patient or Caregiver site?

Resources

enrollment_form

Enrollment

Form

PDF • 435 kb

voucher_enrollment_form

Voucher Enrollment

Form

PDF • 73 kb

pap_form

Patient Assistance Program

Form (PAP)

PDF • 190 kb

authorization_and_consent_form

Patient/Caregiver

Forms

PDF • 83 kb

assessment_confirmation_form

Baseline Assessment

Confirmation

Form

PDF • 98 kb