Enrollment and Authorization Form
OneSource is a patient support program from Alexion that is tailored to the specific needs of people living with rare diseases, specifically aHUS, gMG, HPP, LAL-D, NMOSD and PNH. When you enroll in the program, you’ll work with a dedicated team of OneSource Case Managers who are nurses with expertise in rare disorders and the healthcare system. Your Case Manager is your primary contact with the OneSource program, and is here to help you throughout your journey:
• Education: Collaborating with your healthcare team to answer questions and provide educational materials related to your disease
• Coverage issues and funding options: Assisting patients and practices with insurance coverage questions and research funding options
• Management support: Assisting with solutions for balancing all aspects of disease management when faced with major life challenges.
It only takes a few minutes to enroll. Please complete the following fields: