To enroll your patient in BioMarin RareConnections™, you must complete the Patient Enrollment Form, which serves as the prescription. Your patient or their caregiver must also complete the Patient Authorization Form. Access or download the forms you need to begin enrolling your patient in BioMarin RareConnections.
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Use this form to start enrollment in BioMarin RareConnections.
*This form serves as the prescription for your patient's BioMarin treatment.
Patients must complete the BioMarin RareConnections Patient Authorization Form (PAF) in order to receive support from BioMarin RareConnections. Through this form, patients grant BioMarin permission to use and disclose their health information in order to help them access BioMarin therapies.