Forms & Resources

YourBlueprint™ resources to rely on

Additional tools to help start your patients on AYVAKIT™ (avapritinib)

Ready to enroll your patient in YourBlueprint? Complete the enrollment form today.

Download a patient program overview to inform your patients about the services and support YourBlueprint provides.

Inform your office and others about YourBlueprint with the program overview for providers.

Download a sample letter to provide in case you need to confirm the medical necessity and appropriateness of AYVAKIT for your patient.

Download a sample letter of appeal to use in the event your patient is denied coverage for AYVAKIT.

If your patient requires a dose adjustment, download a dose exchange form to ensure continuity of treatment.
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01/2020     USBP-PSP-19.040.1