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EVIDERA INFUSION ORDERS P: 877.365.5566 | F: 855.889.2946 PATIENT INFORMATION:Fax completed form, insurance information, and clinical documentation to 855.889.2946Patient Name: ___ DOB: ___ Phone:
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Patients who have been prescribed evkeeza evinacumab-dgnb medication.
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Evkeeza (evinacumab-dgnb) is a medication used to treat patients with genetically determined high cholesterol levels. Patient resources related to Evkeeza provide information and support for patients, including usage guidelines, financial assistance, and educational materials.
Healthcare providers, including physicians and clinics that prescribe Evkeeza, are typically required to file patient resources for evinacumab-dgnb to ensure proper patient support and compliance with treatment regulations.
To fill out patient resources for Evkeeza, patients or healthcare providers should complete the designated forms provided by the manufacturer or authorized entity, ensuring all relevant patient information, prescription details, and consent documents are accurately included.
The purpose of patient resources for Evkeeza is to assist patients in accessing the medication, providing educational support about its use, managing financial aspects, and facilitating communication with healthcare professionals.
Information that must be reported includes patient demographics, prescription details, insurance information, consent for treatment and data sharing, as well as any financial assistance needed.
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