Dompé CONNECT to Care
Access support and more through a single point of contact
Providing practices and patients with assistance every step of the way
![](https://oxervate.com/wp-content/uploads/2022/07/Program-enrollment-icon.png)
Program enrollment
![](https://oxervate.com/wp-content/uploads/2022/07/Benefits-verification-icon.png)
Benefits verification
![](https://oxervate.com/wp-content/uploads/2022/07/Prior-authorizations-icon.png)
Prior authorizations
![](https://oxervate.com/wp-content/uploads/2022/07/Patient-financial-assistance-icon.png)
Patient financial assistance
![](https://oxervate.com/wp-content/uploads/2022/07/Delivery-coordination-confirmation-icon.png)
Delivery coordination
& confirmation
![](https://oxervate.com/wp-content/uploads/2022/07/General-questions-icon.png)
General questions
Since approval in 2018, more than 2000 total ophthalmologists and optometrists have prescribed OXERVATE®1
Patient Enrollment
How to enroll a patient
Submit a Patient Enrollment Form
A completed enrollment form serves as the OXERVATE® prescription and enrolls the patient into Dompé CONNECT to Care.
Fax completed enrollment form
on the patient’s behalf.
Use the iAssist digital portal
to complete enrollment.
Remember: Patient Authorization section of enrollment form must be completed.
Questions? Contact Dompé CONNECT to Care