3 Steps to Starting Isotretinoin

Your provider would like to prescribe you isotretinoin (also known as accutane or claravis). To register for this medication, you need to complete these three steps:

Step 1: Please review the following:

iPledge Fact Sheet

For a review of the side effects from isotretinoin and their associated prevalence, please click here

Step 2: Download, Fill, Save

Please fill out and save this form

Consent form


For patients under the age of 18 years, please also save and complete this authorization form

Authorization form


You will need to open the form in Adobe Reader. You can download it free here

Save the filled form onto your computer for upload (step 3)

Step 3: Message Your Dermatologist

For Kaiser patients: Log into KP.org and go to message center. In message center select "Compose" and then choose "Doctor's Office." Select your dermatologist from the list of providers.

Attach the completed form from Step 2 (pdf file)

Journey Forward

Once your dermatology team receives all the completed information, they will be able to set up an enrollment visit to register you on iPledge. Once registered, you may go to the pharmacy to pick up the medication. You have one week from the time of registration to pick up the medication. You will obtain a maximum of 30 days of medication. Your dermatology team will set up another appointment so you can refill the medication. If you run out of the medication a few days before your next appointment, that is fine. The medicine will still remain in your system for a little bit and you should not have a rebound of your acne.

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