DOWNLOADABLE

R E S O U R C E S

Help your patients start and stay on track with their prescribed treatment.
Explore resources and download the forms you need to get started.

Filter by Indication

INSURANCE AUTHORIZATIONS

Prior Authorizations (PAs)

Get help navigating the general PA process.

Appeal Letter Template

If a patient is denied coverage, the following template and instructions can be used to help draft an appeal letter.

Letter of Medical Necessity (LMN) Template

If medical necessity must be shown to gain coverage or formulary exception, the following instructions and template may help.

EXCEPTION LETTERS

Formulary Exception Letter Templates

A formulary exception letter may be able to help a patient gain access by outlining the reasons why a treatment is necessary to meet the medical needs of a patient.

Formulary Exception Letter (Rheumatology)

Formulary Exception Letter (Dermatology)

Formulary Exception Letter (Gastroenterology)

Tiering Exception Letter

DOSING AND CODING GUIDES

RINVOQ Dosing Guide
(Rheumatology)

RINVOQ Dosing Guide
(Atopic Dermatitis)

RINVOQ Dosing Guide
(Ulcerative Colitis)

Coding Guide

SPECIALTY PHARMACY

Specialty Pharmacy Contacts Guide

EDUCATIONAL RESOURCES

PsA Minimal Disease Activity (MDA) Flashcard

AS Disease Activity Brochure

COMPLETE

RINVOQ Complete Enrollment & Prescription Form (Dermatology - Adults) - EXAMPLE

View an example of how to fill out the form to enroll in RINVOQ Complete.

COMPLETE

RINVOQ Complete Enrollment & Prescription Form (Rheumatology)

RINVOQ Complete Enrollment & Prescription Form (Dermatology - Adults)

RINVOQ Complete Enrollment & Prescription Form (Dermatology -
Pediatrics 12+ Years)

RINVOQ Complete Enrollment & Prescription Form (Gastroenterology)

INSURANCE AND BENEFITS

Benefits Verification Chart

Insurance Comparison Booklet

HIPAA AUTHORIZATION

HIPAA Authorization Form

WELCOME RESOURCES

RINVOQ RA Patient Brochure

RINVOQ PsA Patient Brochure

RINVOQ PsA Patient Brochure - Español

RINVOQ AS Patient Brochure

RINVOQ AD Patient Brochure

RINVOQ UC Patient Brochure

Moderate to Severe

RHEUMATOID ARTHRITIS

Practice Resources

RINVOQ Dosing Guide (Rheumatology)

Formulary Exception Letter (Rheumatology)

Patient Resources

RINVOQ RA Patient Brochure

RINVOQ Complete Brochure

Active

PSORIATIC ARTHRITIS

Practice Resources

RINVOQ Dosing Guide (Rheumatology)

Formulary Exception Letter (Rheumatology)

PsA Minimal Disease Activity (MDA) Flashcard

Patient Resources

RINVOQ PsA Patient Brochure

RINVOQ PsA Patient Brochure - Español

RINVOQ Complete Brochure (Rheumatology)

Active

ANKYLOSING SPONDYLITIS

Practice Resources

RINVOQ Dosing Guide (Rheumatology)

Formulary Exception Letter (Rheumatology)

AS Disease Activity Brochure

Patient Resources

RINVOQ AS Patient Brochure

RINVOQ Complete Brochure

Refractory, Moderate to Severe

ATOPIC DERMATITIS

Practice Resources

RINVOQ Dosing Guide
(Atopic Dermatitis)

Formulary Exception Letter
(Dermatology)

RINVOQ Complete Enrollment & Prescription Form (Dermatology - Adults) - EXAMPLE

View an example of how to fill out the form to enroll in RINVOQ Complete.

Patient Resources

RINVOQ AD Patient Brochure

RINVOQ Complete Brochure (Atopic Dermatitis - Adult)

RINVOQ Complete Brochure (Atopic Dermatitis -
Pediatrics 12+ Years)

Moderate to Severe

ULCERATIVE COLITIS

Practice Resources

RINVOQ Dosing Guide
(Ulcerative Colitis)

Formulary Exception Letter
(Gastroenterology)

Patient Resources

RINVOQ UC Patient Brochure

RINVOQ Complete Brochure

AD=atopic dermatitis; AS=ankylosing spondylitis; PsA=psoriatic arthritis; RA=rheumatoid arthritis; UC=ulcerative colitis.