Forms and Documents
Download the form you need to enroll in
OCREVUS Access Solutions.
Start Enrollment With the OCREVUS Start Form
To get started, both you and your doctor must complete this form.
You only need to complete Section 1. The rest of the form must be
filled out by your doctor.
By signing Section 1, you allow OCREVUS Access Solutions to talk about your health information with your doctor and health insurance plan.
You can also submit your section of the form online.
Important Safety Information & Indication
What it Treats
What is OCREVUS?
OCREVUS is a prescription medicine used to treat adults with relapsing or primary progressive forms of multiple sclerosis.
It is not known if OCREVUS is safe or effective in children.
Who should not receive OCREVUS?
Do not receive OCREVUS if you have an active hepatitis B virus (HBV) infection.
Do not receive OCREVUS if you have had a life threatening allergic reaction to OCREVUS. Tell your healthcare provider if you have had an allergic reaction to OCREVUS or any of its ingredients in the past.
Important Safety Information
What is the most important information I should know about OCREVUS?
OCREVUS can cause serious side effects, including:
- Infusion reactions: OCREVUS can cause infusion reactions that can be serious and require you to be hospitalized. You will be monitored during your infusion and for at least 1 hour after each infusion of OCREVUS for signs and symptoms of an infusion reaction.
- Infection: OCREVUS increases your risk of getting upper respiratory tract infections, lower respiratory tract infections, skin infections, and herpes infections. If you have an active infection, your healthcare provider should delay your treatment with OCREVUS until your infection is gone.
What are the possible side effects of OCREVUS?
OCREVUS may cause serious side effects, including:
- Risk of cancers (malignancies) including breast cancer. Follow your healthcare provider’s instructions about standard screening guidelines for breast cancer.
Most common side effects include infusion reactions and infections.
These are not all the possible side effects of OCREVUS.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
For more information, go to www.OCREVUS.com or call 1-844-627-3887