RESOURCES
Find helpful resources for you and your patients.
Enrollment form
Download the enrollment form, work with the patient to complete the form and fax it to 1-833-635-1481 to begin the Kadmon ASSIST enrollment process.
Letter of medical necessity
This template may be used to verify the patient’s need for medical treatment with REZUROCK® (belumosudil) tablets.
Letter of appeal
If a patient’s health insurance plan denies their request for prior authorization or coverage for REZUROCK® (belumosudil) tablets, this templated letter may help with the appeal process.
Kadmon ASSIST brochure
A guide to financial assistance and support for patients on REZUROCK.
PROGRAM ENROLLMENT FORM
Find out which services patients may be eligible for by completing this form. Our Kadmon ASSIST Case Managers can determine which programs are available to patients.
ENROLL FOR CO-PAY SUPPORT
For eligible patients with commercial or private insurance plans.
CONTACT US
Our Kadmon ASSIST team is available to help you Monday through Friday, 8 AM-8 PM ET.
Phone: 1-844-KADMON1 (523-6661)
Fax: 1-833-635-1481