Patient Enrollment

Enrolling your patient allows ARISTADA Care Support to assist with contacting your patient’s health plan to obtain specific coverage details. And it gives us the ability to help your patients navigate other obstacles in receiving their prescribed ARISTADA® (aripiprazole lauroxil) treatment.

Verify benefits in 4 simple steps

  1. Download the Patient Enrollment Form and type in your information on-screen.
  2. Print the completed form and obtain signature of patient or authorized designee.
  3. Fax form to ARISTADA Care Support at 1-844-464-7171.
  4. ARISTADA Care Support will contact your patient’s insurer and provide a summary of your patient’s benefits.

Patient Enrollment Form

Connect your patients to services from ARISTADA Care Support. Co-pay and Patient Assistance Program enrollments are also available on this form.