Enrollment with EASE
Help your eligible patients prescribed COMETRIQ® (cabozantinib) enroll in programs and services available through Exelixis Access Services® (EASE).
You can help enroll your patients in one of two ways
Follow these steps to help enroll your patient in EASE via Docusign.
2. Patient authorization
Share Docusign link with your patient. Patient completes and signs authorization form digitally.
Start Patient Authorization OnlineAlternatively, you can download the patient authorization form for the patient to complete in person. Once complete, this can be faxed back to 1-844-901-3273.
If a patient authorization form is not included with your initial enrollment forms, an EASE case manager will contact the patient directly to coordinate receipt of the authorization form. Important disclosures for California residents.
3. Eligibility confirmation
EASE will confirm your patient’s eligibility for requested services.
Have questions about EASE enrollment? Call our support team at 1-844-900-EASE (1-844-900-3273)
Follow these steps to help enroll your patient in EASE via Fax.
1. Enroll
Download and print the enrollment form. Complete the form in its entirety.
2. Patient authorization
If the patient is in your office, download and print the patient authorization form. Patient completes and signs the form. Attach the completed and signed form with your submission after Step 1.
Alternatively, your patient can complete authorization digitally. Share the Docusign link with your patient and they will complete and sign it.
If a patient authorization form is not included with your initial enrollment forms, an EASE case manager will contact the patient directly to coordinate receipt of the authorization form. Important disclosures for California residents.
4. Eligibility confirmation
EASE will confirm your patient’s eligibility for requested services.
Have questions about EASE enrollment? Call our support team at 1-844-900-EASE (1-844-900-3273)
Looking for something else?
EASE offers separate enrollment into additional programs available to eligible patients
Co-Pay Program
Eligible, commercially insured patients may pay as little as $0 per month. Annual and transaction limits apply.**The Co-Pay Program is not available to patients receiving prescription reimbursement under any federal, state, or government-funded insurance programs or where prohibited by law.
Additional Terms and Conditions apply.
Have questions about
Exelixis Access Services® (EASE)?
Our team is here to help.
Contact us at 1-844-900-EASE
(1-844-900-3273)
We’re available Monday - Friday
8:00 AM to 8:00 PM (ET)