Patient & Physician Resources
GENERAL INFORMATION
Solesta Instructions for Use
In addition, paper copies of the Solesta IFU may be requested by calling (844) 350-9656 . A paper copy will be provided to the requestor within 72 hours.
Solesta Pearls Presentation Solesta Pearls VIDEO with Dr. Bernstein
Patient resources
Solesta Patient Informational BrochureBowel Incontinence Symptom Tracker
Physician resources
ORDERING AND BILLING
Solesta Contact Directory
Solesta Patient Enrollment Form
Coding and Billing Information
SOLESTA REIMBURSEMENT ASSISTANCE PROGRAM (SRAP)
Letter of Medical Necessity Template - Male Letter of Medical Necessity Template - Female Appeal Template - Male Appeal Template - Female
SOLESTA TEMPORARY REBATE INITIATIVE (TRI)
TRI PROCESS OVERVIEW
Solesta Rebate Request Form
Temporary Rebate Initiative Agreement
PATIENT ASSISTANCE PROGRAM (PAP)
PATIENT ASSISTANCE PROGRAM (PAP) ENROLLMENT FORM
Additional Resources
Solesta brings you these additional resources for valuable fecal incontinence–related information to help support your patients.
The following list is not intended to be all inclusive, but it provides a representative sample of the resources available to you:
- American Academy of Family Physicians
- American College of Gastroenterology
- American Society of Colon and Rectal Surgeons
- American Urogynecologic Society
- Cleveland Clinic
- Fecal Incontinence Trial (FIT) Study
- International Foundation for Functional Gastrointestinal Disorders
- Mayo Clinic
- National Association For Continence
- National Institute on Diabetes and Digestive Kidney Diseases
Note: These websites are neither owned nor controlled by Palette Life Sciences. Palette Life Sciences is not responsible for the content or services on these sites.