Complete the steps and a Mirum Cares Club representative will get back to you soon.
Please provide your information so we can confirm you have been prescribed a Mirum medicine and we can review your eligibility to join the Mirum Cares Club. After you complete the steps and submit your request, a Mirum Cares Club representative will review the information you provided to confirm your eligibility. You should hear back about the status of your membership within 1 to 2 business days.
Are you a resident of the United States (mainland US, Alaska, Hawaii, or Puerto Rico)?
Do you have commercial health insurance or commercial prescription drug insurance?Commercial health insurance is private, for-profit, or nonprofit health coverage not administered by the government (unlike Medicare or Medicaid).
Are you currently enrolled in Medicare (including Medicare-eligible retiree coverage), Medicaid, TRICARE/VA/DoD, any other federal or state health or pharmaceutical assistance program, or any employer-sponsored retiree, private indemnity, or HMO insurance plan that covers or reimburses all or part of your prescription drug costs?
By checking this box, I certify that the information provided above is true and correct. I also certify that if any of the above information changes, I will no longer participate in the Mirum Cares Club Program.
I agree to this certification, and I have read, understood, and accept the Mirum Cares Club Program Terms, Conditions, and Eligibility Criteria shown.
This site requires that you submit personal health and contact information in order to enroll yourself or a patient you are a caregiver for in the Mirum Pharmaceuticals Mirum Cares Club Program. As the individual enrolling in the Program, by checking this box, you are confirming that you are 18 years of age or older and have read and understand the Terms of Use and the Privacy Policy of Mirum, that you understand that submission of personal health and contact information is required for participation in the Program, that you authorize Mirum or its designee to utilize the personal health and contact information provided by you for the purpose of providing you with the benefits of the Program and otherwise fulfilling the objectives of the Program, and you are freely providing this information to meet eligibility criteria for participation. If you are a caregiver to a patient, you are representing that you are duly authorized to provide this information, are freely providing it, and are authorized to receive the benefits of the Program on behalf of the patient. Program benefits include the fulfillment of nutritional supplements. You agree that such benefits can be sent to you via direct mail or email, or through telephone communication. By checking this box, or by using this site, you are authorizing Mirum or its designee to contact you by telephone, direct mail, or email in order to receive the benefits. As the individual enrolling the patient or as the patient, you agree that you are 18 years of age or older.
