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OGSIVEO® (nirogacestat)

GOMEKLI™ (mirdametinib)
844-CARES-55 (844-227-3755)Monday-Friday 8 AM-10 PM ET  844-227-3747
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SpringWorks CareConnections Resources & Forms

Additional Resources to Support Your Patients

We provide information you need, when you need it, so you can support your patients on their treatment journey with GOMEKLI (mirdametinib).

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Downloadable Resources

Explore our resources below and visit GOMEKLI.com for more about GOMEKLI.

Enrollment Form

Careconnections Enrollment Form (gomekli) V2

SpringWorks CareConnections 
Enrollment Form

Complete this form to get your patients started with SpringWorks CareConnections today.

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SpringWorks CareConnections Brochures

Springworks Careconnections Hcp Brochure

SpringWorks CareConnections HCP Brochure

Discover the resources available for you and your office staff through SpringWorks CareConnections to help facilitate patient access to GOMEKLI.

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Springworks Careconnections Patient Brochure Gomekli

SpringWorks CareConnections 
Patient Brochure

Share this helpful overview of SpringWorks CareConnections with your patients.

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Sample Letters and Checklists

Sample Letter Of Medical Necessity Or Medical Exception For Gomekli

Sample Letter of Medical Necessity or Medical Exception for GOMEKLI

Refer to this example when a letter of medical necessity or medical exception is appropriate.

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Sample Letter Of Appeal For Gomekli

Sample Letter of Appeal for GOMEKLI

Refer to this example when a letter of appeal of a PA denial is appropriate.

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Alternative Funding Program Afp Sample Letter

Alternative Funding Program (AFP) Sample Letter

Refer to this example when contacting a patient’s insurance provider to request coverage for GOMEKLI where an AFP is involved.

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Gomekli Prior Authorization Pa Tips And Checklist

GOMEKLI Prior Authorization (PA) Tips and Checklist 

This checklist can serve as a guide through the PA process.

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Gomekli Appeals Tips And Checklist

GOMEKLI Appeals Tips and Checklist

This checklist can serve as a guide through the appeals process.

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Peer To Peer Checklist

Peer-to-Peer Checklist

This resource provides a checklist and relevant tips to help you prepare for and engage in a peer-to-peer discussion.

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Additional Resources

Gomekli Treatment Initiation Guide

GOMEKLI Treatment Access Guide

This guide outlines the process for prescribing GOMEKLI and the support services offered by SpringWorks CareConnections that may help address access barriers.

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Gomekli Coverage Tool Kit

GOMEKLI Coverage Tool Kit

This guide provides information and resources to help HCPs and office staff navigate potential access challenges when prescribing GOMEKLI.

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Product Fact Sheet And Ordering Guide (gomekli)

GOMEKLI Product Fact Sheet and Ordering Guide

Find out about GOMEKLI and how to prescribe through our limited network of Specialty Pharmacies or order directly through our Specialty Distributor partners.*

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Evidence Compendium

Evidence Compendium

This resource provides a library of articles that support why GOMEKLI may be medically necessary and should be covered by a patient’s health plan.

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Icd 10 Cm Code Flashcard

ICD-10-CM Code Flashcard

Discover location-specific ICD-10-CM codes.


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Navigating Health Insurance Brochure

Navigating Health Insurance Brochure

Share with patients to help them learn about some of the different types of health insurance as well as select terms related to obtaining coverage.

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Navigating Health Insurance Young Adult Brochure

Navigating Health Insurance as a Young Adult Brochure

Share with young adult patients to help them learn about health insurance and transitioning onto their own health insurance plan.

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Gomekli Electronic Health Record Ehr Flashcard

GOMEKLI Electronic Health Record (EHR) Flashcard

Learn more about how to add GOMEKLI to your EHR system.

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* May not be available for all practices or organizations.

Stay Connected About GOMEKLI

Click here to receive information, updates, and resources for GOMEKLI.

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Enrolling your patient
in SpringWorks
CareConnections is simple

Phone

Have questions?

Call SpringWorks
CareConnections today

844-CARES-55
(844-227-3755)

Monday-Friday 8 AM-10 PM ET
Phone

Have questions?

Call SpringWorks CareConnections today

844-CARES-55
(844-227-3755)

Monday-Friday
8 AM-10 PM ET

Fam

Field Acccess
Manager (FAM) Support

For questions about patient access to GOMEKLI, click to connect with a FAM
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© 2025 SpringWorks Therapeutics, Inc. All rights reserved. C_GOM_US_0083  02/25

OGSIVEO is a registered trademark of SpringWorks Therapeutics, Inc. GOMEKLI and SpringWorks CareConnections are trademarks of SpringWorks Therapeutics, Inc. All other trademarks are the property of their respective owners.

This site is intended for U.S. audiences only.