Helpful and informative resources for you and your patients
KEVEYIS Start Form
This easy-to-use form is the first step in initiating a patient on KEVEYIS. Get your patient(s) started in 3 easy steps:
- Complete the form
- If able, have the patient sign the form
- Fax the form back to 844-KEV-1030 (844-538-1030)
Disease Education Brochure
This printable brochure provides a robust level of information to help you better understand Primary Periodic Paralysis and its diagnosis and management, including:
- Insight into the disease and its diagnosis
- Recommended tests and other evaluations
- Disease management strategies
Primary Periodic Paralysis Daily Tracker & 3-Month Diary
The printable tool is provided for you to give your patients to help them keep track of important aspects of their disease, including:
- And more
Keeping a written record of how they have been feeling and how the disease has affected them between visits will help facilitate more informed conversations during their scheduled appointments with you.
Prior Authorization Checklist
This checklist is a useful resource for ensuring the most common clinical criteria are met when submitting a prior authorization for your patient.
Letter of Medical Necessity
This sample Letter of Medical Necessity outlines support for coverage of KEVEYIS. Use of this document does not guarantee assistance in the payer’s review of a Letter of Medical Necessity for the medication for your patient. Be sure to replace all bolded and bracketed text with the appropriate patient-specific information before forwarding your customized letter to your patient’s insurance provider. If the provided fields do not accurately reflect your practices, please modify them to represent your particular circumstances.
The Periodic Paralysis Association is a nonprofit charitable corporation founded to foster awareness of the periodic paralyses, promote science-based information regarding this class of disorder, and champion the interests of the periodic paralysis community.
A mission-driven, independent and not-for-profit whose goal is to help create successful partnerships between physicians, researchers, and periodic paralysis patients in order to speed diagnosis and improve therapy and management strategies, thereby improving quality of life and clinical outcomes for patients.