How to enroll your patients

To enroll a patient in TASCENSO ODT® (fingolimod) simply click the download enrollment form button below.  Print the enrollment form, complete all required fields and either fax the form to Cycle Vita™ at 888-385-8482 or email it to hello@cyclevita.life.

If you have any questions the Cycle Vita team is only a phone call away.
A friendly, familiar team is waiting here at Cycle Vita, for you and your patients, at every step.
Cycle Vita Logo With Strapline
Cycle Vita Logo With Strapline
A friendly, familiar team is waiting here at Cycle Vita, for you and your patients, at every step.

+1 (888) 360-8482

*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.