The following guide lists the information we need to ensure a quick, seamless patient referral for a Vyepti treatment.
All referrals must include:
- Patient Demographics
- Supporting Clinicals (Notes and Labs)
- Provider name
- Provider signature (or electronically authenticated signature)
- Patient name
- Phone number
- Insurance information (primary and secondary if applicable)
Supporting Clinicals (Notes and Labs):
- Clinicals to support an indication for the preventive treatment of migraines in adult patients
- Patient has a history of migraines and has been on 2 oral preventatives and has experienced 4 or more migraines within a month period
Ready to make a referral?
Download our Vyepti Order Form.
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