Secura Care™ Patient Support Program

Secura Care™ Patient Support Program

For help with insurance verification, co-pay and reimbursement resources, please call:

844-9SECURA [ (844) 973-2872 ]

Monday to Friday 10:00 AM to 7:00 PM ET

Patients are required to sign the FARYDAK® Patient Authorization form to give the Patient Support Specialists at SecuraCare permission to access personal health information. Personal health information will be used to help with treatment, and will be kept confidential. The authorization form can be signed and submitted online, or by downloadable PDF, which must be printed, filled out, signed, and faxed.

Patients, Sign and Submit

Download or Submit Online

Or Download and Print

Enrollment Form