How to enroll

If you are interested in enrolling your patients in PHYRAGO™ (dasatinib) tablets, download the enrollment and patient consent forms below.
Where do I send a PHYRAGO prescription?
Once you have completed the PHYRAGO enrollment form, you can send it to our patient support* program, Cycle Vita™, where our expert team will take care of all the details so your patients can get started on their PHYRAGO treatment as soon as possible.
Email the completed form to hello@cyclevita.life
Fax it to 888-385-8482
To ensure faster turnaround times for you and your patients, please see our Rx Checklist to make sure you include everything required for a quick process.
PHYRAGO has a limited distribution. If your patients are contacted by someone who is not from Cycle Vita or their Specialty Pharmacy, please let us know at 888-360-8482 or hello@cyclevita.com.
*Some areas of support may not be accessible to all patients. Eligibility criteria may apply to ensure compliance with all applicable federal and state requirements, and benefits may be limited to commercially insured patients only. For more detailed information about eligibility, terms and conditions, please contact the Cycle Vita team at 888-360-8482.
