Gilenya Start Form - Please include copies of both sides of all insurance plan cards. For children ages 10 & oider. Find out if you are eligible and how to enroll in the gilenya go program. Web starter product is optional and available at no cost to the patient. See full prescribing & safety info. Web as of january 1, 2023, no new patient start forms will be accepted for the gilenya go program. Interested in gilenya for your child as young as 10? It is dispensed directly from the gilenya go program®. Once your health care professional submits this start form, you'll be automatically enrolled in the go program and on your way to starting gilenya.
For children ages 10 & oider. Once your health care professional submits this start form, you'll be automatically enrolled in the go program and on your way to starting gilenya. Find out if you are eligible and how to enroll in the gilenya go program. It is dispensed directly from the gilenya go program®. Interested in gilenya for your child as young as 10? Web as of january 1, 2023, no new patient start forms will be accepted for the gilenya go program. Please include copies of both sides of all insurance plan cards. See full prescribing & safety info. Web starter product is optional and available at no cost to the patient.