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Bamlanivimab Emergency Use Authorization Order Patient Name: Date of Birth: Address: Height (in.): Phone#: Weight (Kg): Ordering Provider: Phone: Address: Patient has a confirmed positive test and
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Who needs casirivimab and imdevimab emergency?

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Casirivimab and imdevimab emergency is intended for individuals aged 12 years and above, weighing at least 40 kg.
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It is recommended for patients who have tested positive for COVID-19 and are at high risk of developing severe symptoms or requiring hospitalization.
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Specific eligibility criteria may be determined by healthcare professionals.
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Casirivimab and imdevimab are monoclonal antibody treatments authorized for emergency use to prevent and treat COVID-19 in certain patients at high risk of severe disease.
Healthcare providers who administer casirivimab and imdevimab treatments are required to file emergency use documentation with the appropriate health authorities.
To fill out the emergency use documentation, providers must provide patient information, treatment details, and any adverse effects observed during administration.
The purpose is to enable rapid access to these monoclonal antibodies for at-risk patients during the COVID-19 pandemic to reduce the risk of severe disease.
Providers must report patient demographics, treatment dates, dosage administered, any adverse events, and outcomes following treatment.
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