Spravato Rems Enrollment Form - Web spravato rems patient enrollment form. Web to enroll in rems online, you must create an online account by filling out and submitting the registration form at spravatorems.com.†. This section is to be completed by the patient. Review the spravato® prescribing information and the spravato® rems program overview. Find out the requirements, steps, and resources for safe and appropriate use of spravato. Web spravato (esketamine) nasal spray ciii is a treatment for depression and suicidal ideation, but requires certification and enrollment in a rems program. This form is intended only for use by outpatient medical ofices or clinics, excluding emergency departments. Options for enrolling in rems. This section is to be completed by the prescriber. Use the online registration to ensure all required fields on the enrollment are accurately captured before submission.
This section is to be completed by the patient. This form is intended only for outpatient medical ofices and clinics. Web learn how to become and maintain a certified spravato treatment center under the rems program. Use the online registration to ensure all required fields on the enrollment are accurately captured before submission. Learn how to become certified as a healthcare setting, pharmacy, or patient, and what are the risks and benefits of spravato. Web spravato rems patient enrollment form. This section is to be completed by the prescriber. First name* last name* birthdate*: Web to enroll in rems online, you must create an online account by filling out and submitting the registration form at spravatorems.com.†. Web spravato (esketamine) nasal spray ciii is a treatment for depression and suicidal ideation, but requires certification and enrollment in a rems program. This form is intended only for use by outpatient medical ofices or clinics, excluding emergency departments. If using a paper form, ensure all answers are legible. This form is intended only for use by outpatient medical ofices or clinics, excluding emergency departments. Find out the requirements, steps, and resources for safe and appropriate use of spravato. Options for enrolling in rems. Your healthcare provider will help you complete this form and provide you with a copy. Review the spravato® prescribing information and the spravato® rems program overview.