Enroll
How to Enroll Your Patients
There are two ways to enroll patients in the Cycle Vita hub for SAJAZIR (icatibant). Either complete the online enrollment form, or print and fax an enrollment form to Cycle Vita. Please select the option best for you and the Cycle Vita team will get started enrolling your patient in the hub.
Enroll by form
If you are interested in enrolling a patient in the Cycle Vita hub for SAJAZIR, simply click the download form button below. Print the enrollment form, complete all required fields and fax the form to Cycle Vita at + 1 (888) 385-8482.
Enroll online
If you would prefer, you can click the button below and fill out the SAJAZIR enrollment form online. Simply enter your text into the fields and click enroll – the form will be sent to the Cycle Vita team in a secure and compliant manner.
If you have any questions during the enrollment process, the Cycle Vita team are only a phone call away.
A friendly, familiar team is waiting here at Cycle Vita, for you, at every step.

hello@cyclevita.life
+1 (888) 360-8482
www.cyclevita.life