Invokana - Forms & Documents
- Benefits Investigation FormA way to find out if INVOKANA® is covered by the patient's insurance plan, including requirements for coverage or prior authorization, any out-of-pocket costs, and approved pharmacies.
- Business Associate AgreementComplete a Business Associate Agreement for your practice only once. No individual patient authorizations are required.
- Letter of ExceptionA template that you can fill out and submit to a patient’s health insurance provider asking them to cover a medication that is not on formulary.
- Letter of Medical NecessityA template that you can fill out and submit to a patient’s health insurance provider. You may use it to explain why INVOKANA® is medically necessary for your patient.
- Patient Account Overview
- Patient Affordability OptionsDiscover options that can make INVOKANA® more affordable for your patients.
- Patient Authorization FormIndividual patient form for offices without a Business Associate Agreement.
Patient Authorization Form (en español) - Patient Authorization Form (en español)Individual patient form for offices without a Business Associate Agreement.
- Resources for PatientsLearn about offers that can help patients get started and stay on track with INVOKANA®.
- Savings Program OverviewEligible patients using commercial or private insurance can save on out-of-pocket costs for INVOKANA®.
- Savings Program Rebate FormA form the patient can submit if the pharmacy isn’t able to process the Janssen CarePath Savings Program card.
- Verification of Benefits Guide (Pharmacy)A guide to understanding the Verification of Benefits for your patient’s pharmacy benefits.

Invokana - Forms & Documents
Invokana - Forms & Documents