Information to Help Your Patients Access AFSTYLA

Simplified support starts with My SourceSM for AFSTYLA

Help your patients access financial support and further their understanding of hemophilia A.

Getting your patients started with AFSTYLA is simple.

  • Start patient on AFSTYLA with a free 30-day trial
  • Fill out an AFSTYLA Patient Referral form to enroll your patient in the AFSTYLA Support program and begin a benefits investigation
  • Fax completed forms to My Source at 1-844-727-2757

A My Source Care Coordinator will contact you and your patient to help complete the enrollment process. Contact My Source with any questions.

For more information, call a
My Source Care Coordinator
Monday–Friday, 8 am to 8 pm ET.

Commonly requested administrative materials

Available to view, print, or download.

AFSTYLA Patient Referral Form

Reimbursement Form and Coding Guide

Find out how AFSTYLA
support can help your patients

Have a CSL Behring representative contact you: Continue to submit your request

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