Download helpful resources 

Feraheme AssistTM Patient Enrollment Form
Use this form to enroll your patients in Feraheme Assist, a program that provides individualized support to your patients. Fill out the information, ensure both you and your patient sign it, and fax to 877-591-2505.
Sample Letter of Appeal
You can use this template to help you write a letter of appeal if a health plan denies FERAHEME coverage.
Referral Form
You can use this form to refer your patients to another physician to receive FERAHEME.
Radiologist Letter
This letter provides radiology departments information on how to adjust the MRI equipment for patients who have had a recent FERAHEME injection.
AMAG Returns and Replacement Policy
This form can be used to review the FERAHEME returns and replacement policy as well as to submit a product replacement request.
Feraheme Assist™ Brochure
This brochure provides an overview of Feraheme Assist, a program that provides individualized support to your patients.
Billing and Coding Brochure
This brochure helps with billing and coding for outpatient services. Codes include product, administration, and diagnosis codes, as well as coding for IDA underlying conditions.

IDA=iron deficiency anemia; MRI=magnetic resonance imaging.

FERAHEME patient brochure (English)
Educational material that provides your patients with the information they need to get started on FERAHEME.
FERAHEME patient brochure (Spanish)
Educational material that provides your patients with the information they need to get started on FERAHEME.