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Options for getting your patients started with ONPATTRO® (patisiran)

In order to make the process convenient for you and your patient, Alnylam Assist provides 3 separate options for initiating and completing the Start Form.

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Electronic Start Form

Complete and submit the Electronic Start Form online with your patient

 

OR

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Downloadable Start Form

Print, complete with your patient, and fax the Start Form to 1-833-256-2747

 

OR

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DocuSign Start Form

Begin the Start Form and send to your patient over email to complete via DocuSign

 

What happens next:

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Your patient's dedicated Case Manager will reach out to you and your patient within 1-2 business days of receiving a completed Start Form.

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The Alnylam Assist team will facilitate acquisition of ONPATTRO for your patient via specialty distributor or specialty pharmacy. For some patients, home infusion may also be an option.

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