Downloadable Resources for Patients

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Helpful Forms and Documents for Your Nerivio Journey

Whether you’re starting treatment or navigating insurance coverage, we’ve gathered the key resources in one place. Download forms, coverage support tools, and shcool notices to help make your Nerivio experience as smooth and supported as possible.

Helpful Forms and Documents for Your Nerivio Journey

Nerivio Prescription Form

Nerivio can be prescribed by any doctor, nurse practitioner or physician assistant. Consult with a healthcare provider about using Nerivio and present the downloaded prescription form for accurate pharmacy info.

After a healthcare provider prescribes Nerivio for you, our distributor partner  will contact you to obtain your insurance and payment information.

Nerivio will then be delivered to your doorstep with no shipping costs.

Download Prescription Form >
Insurance Advocacy Sample Letter

Your insurance doesn’t cover Nerivio? Wondering how to approach your insurance company about getting coverage?

Download a sample letter to see how others have successfully communicated with their insurers.

(Note: This letter is for reference only and should not be copied directly.)

Download Insurance Advocacy Sample Letter >
Sample Letter: Optional School Nurse Communication for In-Class Nerivio Use (For HCP Use)

Nerivio is a drug-free, wearable migraine treatment that can be used discreetly in class. While most schools allow its use without issue, some with phone restrictions may require written permission.

Download a sample letter to help your healthcare provider communicate with the school if needed.

(Note: For reference only – not intended for direct use.)

Download School Nurse Sample Letter >