Enrollment Forms

To begin the enrollment process:

  1. Search by product name or disease state

  2. Print the PDF of the Enrollment Form

  3. Fax the completed form with pertinent labs and signed by the prescriber back to us at 865.999.7825

Enrollment forms and prescriptions can only be accepted if faxed directly from the prescriber's office.

Search for drug by Disease State:

Prior Authorizations

Our staff have been trained to deal with all aspects

of the prior authorization process. Once you connect

with one of our staff members, they will complete the

entire process from beginning to end and communicate

the results back to your office. 

Simplified Communications

You can reach our pharmacist or any of our

staff members by text, instant message,

email or phone. We promptly return

communication from messages the day

as soon as possible.

Clinical Management

We are trained to monitor our patients therapy

and to help them with side effects. We will

communicate this information back to you

Upload documents effortlessly

Either fax the documents to 865.281.3392 or email

to ask@mybelieverx.com

Financial Assistance

We will help our patients find a way to cover the

cost of their medication, whether it be from the 

drug company or an outside source.

Personal Touch Patient Management

We realize patients on specialty medications need a

personal touch and should not have to rely on the mail.

Our pharmacist wants to go out to the home to counsel

the patient in their own environment and delivery the

medication themselves.

24/7 Availability

We have someone available 24/7 to take calls or questions.

Speak with someone from the pharmacy at the

click of a button

Utilize instant message or talk to someone on live chat.

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