Our Kadmon ASSIST team is
available to help you Monday
through Friday, 8 AM-8 PM ET.

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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.

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Letter of medical necessity

This template may be used to verify the patient’s need for medical treatment with REZUROCK® (belumosudil) tablets.

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REZUROCK ordering form

Find out how to order REZUROCK for your account.

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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.

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Kadmon ASSIST brochure

A guide to financial assistance and support for patients on REZUROCK.

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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.

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Enroll for
Co-Pay Support

For eligible patients with commercial or private
insurance plans.

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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