Specialty Enrollment Forms

We are proud to offer quick and easy new patient enrollment directly in our Stream portal!  Navigate to Provider Actions and click “Enroll New Patient” to begin our simple electronic enrollment. 

If you prefer to use paper enrollment forms, please click the appropriate “Download Now” link below to access the form needed.  Once completed, you can upload the paper enrollment form directly in Stream as well.

Brixadi Enrollment Form

HEPC Enrollment Form

Lucemyra Enrollment Form

Sublocade Enrollment Form

Vivitrol ENROLLMENT FORM