Enroll eligible patients

Help your patients get treatment support
Start your patients on their treatment
journey with comprehensive support
services from Madrigal Patient Support.
Three ways to enroll your eligible patients

Enroll with paper form
You can download and print the enrollment form, fill it out, and fax it to 1-844-411-1177.
Ensure your patients have completed their consent
Patients can sign the Madrigal Patient Support enrollment form in person at your office, or they can sign the eConsent form electronically.

Once enrolled, patients can expect a welcome call
Once you’ve enrolled your patient, their dedicated Case Manager will call within a few days to:
- give them an overview of the program
- inform about coverage and/or potential financial assistance options for their medicine
- share available resources
- answer questions they may have to help them get started
You may want to let your patient know to expect a call from Madrigal Patient Support.