Our interactive enrollment forms make sending prescriptions easy. Simply download the fillable form, type or print the appropriate information and return to WellDyne Specialty Pharmacy via fax – (800) 530 8589.

Once we receive the completed disease-specific enrollment form, WellDyne Specialty Pharmacy will:

• Verify and coordinate insurance coverage
• Provide prior authorization and financial assistance
• A Patient Care Advocate will be assigned to the patient to coordinate medication delivery and assist with questions and medication compliance