Forms and resources

Find informative resources and guides below to learn more about how to enroll your patients in AkebiaCares and help them access their Akebia product.

Not an actual patient Not an actual patient

Enrollment

AkebiaCares enrollment form

Fill out this form to get access to a dedicated Case Manager.

AkebiaCares enrollment form tips

Helpful tips to consider when filling out the AkebiaCares enrollment form.

Patient Assistance Program (PAP) re-enrollment form

Download and fill out this form to keep patients enrolled in PAP.

Patient consent form

You do not need to fill out this form if you are completing an AkebiaCares enrollment form.

Resources to help access medication

Affordability flashcard

Discover available resources for every type of insurance.

Pharmacy locator

Find pharmacies that best fit your patients’ needs and get connected to a specialty pharmacy locator.

Help for patients with Medicare

Patients with government insurance may be able to receive financial assistance from independent third-party foundations, such as:

Prior Authorization and appeal guidelines

Considerations for submitting a Prior Authorization

What to know when submitting a Prior Authorization.

Considerations for composing an Appeal Letter

Helpful tips to write and submit an Appeal Letter.