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Discard vial in sharps container. If vial has a manufacturer s defect broken seal particles or cloudy solution record and return vial to transfusion service. Date product picked up Date wasted Check one not both of vials Wasted Expired If wasted indicate whether returned to Transfusion Service Thigh Mail completed forms to Aug 2014 ATTN Interior Health SCIG Program Kelowna Community Health and Service Center 505 Doyle Ave Kelowna BC V1Y 0C5 Revised from BC Provincial Blood Coordinating...
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What is download form hizentra referral?
Download form hizentra referral is a document used to request Hizentra, a medication used to treat primary immunodeficiency, for a patient.
Who is required to file download form hizentra referral?
Healthcare providers or medical facilities who are prescribing Hizentra for a patient are required to file the download form hizentra referral.
How to fill out download form hizentra referral?
To fill out the download form hizentra referral, healthcare providers need to provide patient information, prescription details, and medical necessity justification.
What is the purpose of download form hizentra referral?
The purpose of download form hizentra referral is to request authorization for the use of Hizentra for a patient with primary immunodeficiency.
What information must be reported on download form hizentra referral?
The download form hizentra referral must include patient demographics, diagnosis, prescription details, and medical necessity explanation.
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