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Get started with enrollment
Together with EXDENSUR offers a range of assistance options at no cost to you. After your doctor has prescribed EXDENSUR, you can choose how you want to enroll in the program. Follow the steps below to begin!
Start enrollment in three easy steps
Choose an option below
Start online or download—whatever works best for you.
Complete and sign
Sign as marked or provide your digital signature.
Review and submit
Make sure all required fields are completed by you.
Enroll in the Copay Program
By enrolling in the EXDENSUR Copay Program, eligible commercially insured patients could possibly pay as little as $0† per dose for EXDENSUR. You'll also gain access to educational resources and support.
†Subject to program maximums. See full Terms and Conditions.
Download and print
If you are enrolling in Together with EXDENSUR with your doctor, you can download and print an enrollment form, which will guide you and your doctor through the steps. Once the form is received and your enrollment is processed, you’ll gain access to the appropriate services.
Answers to some initial questions you may have about Together with EXDENSUR
We are here to help!
For more information about enrollment, or if you need help with the process, reach out to your Patient Navigator at 1-844-225-5894 (844-Call-TwGSK).
Monday–Friday: 8:00 AM – 8:00 PM ET