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FUNGAL INFECTIONS Managed/Excluded Formulary Exception Member Request Form Please have the prescribing physician complete the physician portion and questions and then submit this completed form. Send

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How to fill out fungal infections

01

First, thoroughly clean and dry the affected area.

02

Apply an over-the-counter antifungal cream or powder to the infected area.

03

Make sure to follow the instructions on the product label for proper application.

04

Avoid wearing tight-fitting or non-breathable shoes and socks.

05

Keep your feet clean and dry, especially between the toes.

06

Change your socks and shoes regularly to prevent moisture buildup.

07

If the infection persists or worsens, consult a healthcare professional for further evaluation and treatment.

Who needs fungal infections?

01

Anyone can develop fungal infections, but certain individuals are more susceptible.

02

People with weakened immune systems, such as those with HIV/AIDS or undergoing chemotherapy, are at higher risk.

03

Individuals with diabetes or peripheral artery disease also have an increased likelihood of developing fungal infections.

04

Athletes and people who frequently engage in activities that cause excessive sweating are prone to such infections.

05

Wearing tight or non-breathable footwear, sharing personal items with an infected person, and walking barefoot in public places can also increase the risk.

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What is fungal infections?

Fungal infections are caused by fungi that invade the body and are typically treated with antifungal medications.

Who is required to file fungal infections?

Medical professionals and healthcare providers are required to report cases of fungal infections to public health authorities.

How to fill out fungal infections?

Fungal infections can be filled out by documenting the patient's symptoms, laboratory test results, and treatment provided.

What is the purpose of fungal infections?

The purpose of reporting fungal infections is to track and monitor the spread of these infections and to prevent outbreaks.

What information must be reported on fungal infections?

Information such as the patient's demographics, medical history, and laboratory test results must be reported on fungal infections.

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