Forms & Resources
Forms and resources
If you have not yet finalized your enrollment in YourBlueprint™ with your healthcare provider, complete the process today by providing your consent online (facilitated through DocuSign).
If you would prefer not to provide your consent online, you can simply complete this form and send it to the email, fax, or mailing address provided on the consent form.
Tell a family member or friend about YourBlueprint: print an overview of the services and support we offer.
YourBlueprint is just a call away. Take a look at some of the questions we are most frequently asked:
Once you have been prescribed a Blueprint Medicines therapy, your healthcare provider can enroll you into the program. To complete your enrollment, you will need to provide your consent in-office, online (facilitated through DocuSign), or in writing. If you choose to provide your consent in writing, you can send your completed form via:
- - Email: firstname.lastname@example.org, or
- - Mail: PO Box 15590, Pittsburgh, PA 15244
YourBlueprint is a free resource for patients who have been prescribed a Blueprint Medicines therapy.
You should contact your healthcare provider immediately if you are having any side effects. You may also contact Blueprint Medicines at 1-888-BLUPRNT (1-888-258-7768) or the Food and Drug Administration (FDA) at 1-800-332-1088 to report any side effects.
- American Cancer Society – "A nationwide, community-based voluntary health organization that provides patients and caregivers with a variety of support from free lodging and transportation to help making decisions about your care."
- CancerCare – "A national organization offering case management, counseling, and support groups, along with educational workshops, publications, and financial and co-pay assistance."
- Cancer Support Community – "CSC and its Gilda's Club affiliates provide free support services to patients and families in person, over the phone, and online, and delivers cutting-edge research and leading public policy solutions."
- Patient Advocate Foundation – "A nonprofit organization which provides case management services and financial aid to Americans with chronic, life threatening, and debilitating illnesses."
- GIST Support International – "An all-volunteer, non-profit organization that reaches out to GIST patients and their families and friends to provide education and support."
- The Life Raft Group – "Supporting GIST patients with patient-powered research, education, empowerment, and global advocacy to improve survival and quality of life."
- GO2 Foundation for Lung – "A national lung cancer nonprofit offering information, educational resources, and support to patients and caregivers."
- LUNGevity Foundation – "The largest national lung cancer-focused nonprofit organization that provides patients and caregivers with lung cancer education, resources, and support."
- RET Renegades – "RET Renegades is a closed Facebook group of patients with RET fusion-positive lung cancer, and their caregivers. It's a great place for helpful information, and most importantly, it's a forum for support and advocacy."
These advocacy groups are included as a reference for patients, and do not imply endorsement of the company or its products by the groups listed. Blueprint Medicines is not affiliated with and does not endorse any particular advocacy group. We make no guarantees about the accuracy of the information provided on advocacy groups’ websites or the quality of support provided. Descriptions of advocacy group resources and activities have been provided by the independent advocacy groups.