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Epinephrine, SelfInjected Prior Authorization Request Form Please complete this entire form and fax it to: 8669407328. If you have questions, please call 8003106826. Section A Member Information First
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How to fill out epinephrine self-injected
How to fill out epinephrine self-injected
01
To fill out epinephrine self-injected, follow these steps:
02
Remove the cap from the auto-injector.
03
Hold the auto-injector firmly with your thumb and fingers.
04
Place the tip of the auto-injector against the outer thigh.
05
Push the auto-injector firmly into the thigh until it clicks.
06
Hold the auto-injector in place for a few seconds.
07
Remove the auto-injector from the thigh.
08
Massage the injection site for 10 seconds.
09
Seek immediate medical attention after administering the epinephrine.
Who needs epinephrine self-injected?
01
Epinephrine self-injected is needed by individuals who have a severe allergic reaction known as anaphylaxis.
02
This can occur in people who have severe allergies to certain foods, medications, or insect stings.
03
It is important for these individuals to carry epinephrine with them at all times to be prepared for any potentially life-threatening allergic reactions.
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What is epinephrine self-injected?
Epinephrine self-injected is a medication that can be administered by an individual to treat severe allergic reactions.
Who is required to file epinephrine self-injected?
Individuals who have been prescribed epinephrine auto-injectors are required to have them on hand in case of an emergency.
How to fill out epinephrine self-injected?
Epinephrine self-injected devices typically come with instructions on how to properly use them in case of an allergic reaction.
What is the purpose of epinephrine self-injected?
The purpose of epinephrine self-injected is to quickly administer a dose of epinephrine in case of a severe allergic reaction, such as anaphylaxis.
What information must be reported on epinephrine self-injected?
Information such as the expiration date, lot number, and proper storage instructions should be reported on epinephrine self-injected devices.
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