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CASANOVA INFUSION & MEDICAL CENTER 1._________Patient NameDOBPatient Phone/Cell #Patient demographic and insurance information to be faxed with Infusion Order Form2. Medical Information (Please complete/select
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How to fill out study using cabenuva for

01
Make sure you have been properly instructed by your healthcare provider on how to administer Cabenuva.
02
Remove the Cabenuva pouch from the refrigerator and allow it to reach room temperature.
03
Clean the injection site with an alcohol wipe and let it dry.
04
Use the needle to draw the medication into the syringe.
05
Administer the injection as instructed by your healthcare provider.
06
Dispose of the used syringe and needle properly.

Who needs study using cabenuva for?

01
Patients with HIV who are stable on oral cabotegravir and rilpivirine and are looking for a long-acting treatment option.
02
Patients who have difficulty adhering to daily oral medication regimens.
03
Patients who have discussed the risks and benefits of Cabenuva with their healthcare provider.
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Cabenuva is used for the treatment of HIV-1 infection in adults.
Healthcare providers prescribing Cabenuva are required to file the study for monitoring purposes.
The study using Cabenuva can be filled out online through the designated reporting portal.
The purpose of the study using Cabenuva is to monitor the effectiveness and safety of the treatment in patients.
The information reported should include patient demographics, treatment regimen, and any adverse events experienced.
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