Your HCP will need to complete the enrollment form with you and submit it to the Paxman Hub.

The Paxman Hub case managers will review and process the request, and then contact you for payment. Once payment is received, the pharmacy will quickly ship the Paxman Personal Cap Kit directly to your home. The cap arm has a pre-paid token which activates the Paxman Scalp Cooling System.

Your HCP should have an enrollment form ready to complete however please download the form here and print a black and white copy.