Two women on a walk outside.

Starting or Switching Patients
to BAFIERTAM® Is Easy

Two women on a walk outside.

Cycle VitaTM offers individualized product and process support*
to help your patients start and stay on treatment with BAFIERTAM.

Where can I send a BAFIERTAM prescription?

Once you have completed the enrollment form, you can send it to our patient support program, Cycle Vita, where our expert team will take care of all the details so your patients can get started on their treatment as soon as possible.

You can either:

1. Email the completed form to hello@cyclevita.life, or
2. Fax it to 1-888-385-8482

Please use the enrollment form on the BAFIERTAM website, and remember to specify dispense as written (DAW) on every form, new or refill, to ensure that your patients receive BAFIERTAM and the support available through Cycle Vita.

If your patients are contacted by someone who is not from Cycle Vita or their Specialty Pharmacy, please let us know at 1-888-385-8482 or hello@cyclevita.life.

To ensure faster turnaround times for you and your patients, please see our Rx Checklist to make sure you include everything required for a quick process.

Start prescribing your patients with the BAFIERTAM patient enrollment form. Start prescribing your patients with the BAFIERTAM patient enrollment form.

Start prescribing with
the
patient enrollment
form

DOWNLOAD FORM

Patient consent
form

DOWNLOAD FORM

*Some areas of support may not be accessible to all patients. Eligibility criteria may apply to ensure compliance with all applicable federal and state requirements, and benefits may be limited to commercially insured patients only. For more detailed information about eligibility, terms and conditions, please contact the Cycle Vita team at 888-360-8482.