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Xyrem Rems Prescription Form. Print and sign the completed xywav or xyrem prescription form for your patient : Fax to xywav and xyrem rems:
Web download the xyrem prescription form: Web the online rems patient enrollment form can be found here. Submit the completed and signed front page of the xywav prescription form to the certified pharmacy by either: Web the prescription form is used for initial prescriptions and for patients who are reinitiating xyrem after a lapse in therapy of 6 months or longer. Fax to xywav and xyrem rems: 1 the prescription form can also be used for refills and renewals. Web form available online at www.xywavxyremrems.com. Print and sign the completed xywav or xyrem prescription form for your patient : Fax to xywav and xyrem rems: Web form available online at www.xywavxyremrems.com.
Print and sign the completed xywav or xyrem prescription form for your patient : Web download the xyrem prescription form: Submit the completed and signed front page of the xywav prescription form to the certified pharmacy by either: Fax to xywav and xyrem rems: 1 the prescription form can also be used for refills and renewals. Web form available online at www.xywavxyremrems.com. Fax to xywav and xyrem rems: Web the online rems patient enrollment form can be found here. Print and sign the completed xywav or xyrem prescription form for your patient : Web form available online at www.xywavxyremrems.com. Web the prescription form is used for initial prescriptions and for patients who are reinitiating xyrem after a lapse in therapy of 6 months or longer.
