Step 1: Inquiry.

The first stage of every case is an intake: a short written description of what the patient needs, who is prescribing it, and where it needs to go. It is deliberately a low-friction first step; most families can complete the intake in ten or fifteen minutes, and most prescribers can do it from the clinic in the same window. What that short submission produces on our side is an initial feasibility signal, usually within one business day, and that signal determines whether the case moves forward into clinical and regulatory review or whether we decline at the door.

What a patient or family submits

From a patient or a family member, we ask for the patient's name and country of residence, the name of the treating physician and the hospital or clinic where they practice, the drug that has been recommended, the indication, and a short narrative description of what has happened so far. We do not require the prescription itself at this stage, but if the family has the written prescription or a medical-necessity letter from the physician, attaching it shortens the review window significantly. We ask families not to send medical records at intake; those come later if the case moves forward.

What a prescriber submits

From a prescriber, we ask for the drug, the indication, the treatment plan, and the destination. Where the prescriber has already drafted a medical-necessity letter, attaching it at intake lets us assess regulatory feasibility in a single pass rather than across two exchanges. Prescribers submitting multiple cases for different patients can use our prescriber intake channel, which allows case batching while keeping each case separately adjudicated.

Our initial screening and SLA

When an intake lands, it is routed to a case-intake coordinator who performs a lightweight sanity check: is the drug one we can source through our US specialty wholesale chain; is the destination country one we operate into for this indication; is the prescriber identifiable and reachable; are the basic elements of the request internally consistent. That screen is quick, and most cases pass it without adjustment. The case is then tagged for clinical and regulatory review, and we send an acknowledgement back to the submitter within one business hour confirming the intake was received and flagging anything that needs a quick clarification. The formal feasibility signal, which is our indication of whether the case is workable and on what rough timeline, is returned within one business day. For cases that come in outside our business hours, the one-business-day clock starts at the next business open.

What comes back

The feasibility signal we return is one of four outcomes. The first is a go-ahead, meaning the case looks workable and the next step is to move into clinical review; in that outcome, we ask for the specific documents we need to proceed. The second is a conditional go-ahead, meaning the case looks workable pending a specific piece of information, typically a clarification from the prescriber or a confirmation of pack size; in that outcome, we identify what we need and hold the case open. The third is a pause, meaning we see an issue that may be resolvable but needs more work before we can commit; in that outcome, we explain what the issue is and suggest what the family or prescriber might do next. The fourth is a decline, meaning the case falls into one of the three decline categories we have published; in that outcome, we say so candidly and point to a referral. We do not charge for any intake, whatever the outcome; the coordination fee attaches only when a case moves forward into active coordination.

What happens after a go-ahead

When a case receives a go-ahead or a conditional go-ahead at intake, the next move is to open a secure file and request the specific documents clinical and regulatory review will need. Those documents typically include the written prescription, the medical-necessity letter, the patient's relevant medical history for the indication, any prior treatment documentation the prescriber wishes us to see, and the patient's consent for cross-border coordination under a named-patient pathway. We provide a templates package that includes a medical-necessity letter template and a named-patient consent template to reduce the paperwork burden on prescribers. Once the documents arrive, the case moves into clinical review.

What we ask families not to do at intake

We ask families not to send payment at intake. There is nothing to pay for yet, and we do not accept deposits against a case that has not cleared review. We ask families not to send full medical records until we request specific elements; a complete hospital chart is unnecessary at this stage and creates unnecessary privacy exposure. And we ask families not to send confidential material through consumer messaging apps; the consultation channel on our site uses encrypted intake and is the right route for anything that includes patient identifiers or clinical detail.

Reviewed 2026-04-22 by Reserve Meds’s AI clinical and regulatory review agents. Human pharmacist-in-charge: Altima Care. Next scheduled review: 2026-10-22.