The ENcourage Foundation® forms have recently changed. To download the latest versions, click on the links below. Please note, as of May 24, 2010 previous versions of the ENcourage Foundation® Patient Application Packet and Product Prescription Form will no longer be accepted.

The patient application packet includes the Patient Application Form and the Product Prescription Form. All documents must be completed and signed to avoid delays in processing. Detailed instructions for completing the application packet are also included.

The Product Prescription Form is included in the application packet above and is also available as a standalone form. This form must be completed and signed by the patient’s physician as part of the initial application process. A new form must be completed every year as part of the re-enrollment process, or anytime the patient’s ENBREL prescription changes.