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This document has been approved for use at []PATIENT CONSENT FORM USE OF SOTROVIMAB IN ADULTS WITH COVID-19 Sotrovimab (Every) is a provisionally registered for use in Australia for the treatment
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How to fill out authorization of sotrovimab for
How to fill out authorization of sotrovimab for
01
Obtain the authorization form from the appropriate health authority or organization.
02
Fill in the patient's personal details, including full name, date of birth, and contact information.
03
Provide medical history relevant to the use of sotrovimab, including any allergies or prior treatments.
04
Include details of the current COVID-19 diagnosis, such as test results and symptoms.
05
Specify the reason for requesting sotrovimab, including any relevant clinical considerations.
06
Complete any required sections regarding insurance or payment information.
07
Review the form for accuracy and completeness.
08
Submit the authorization form to the designated health care provider or insurer.
Who needs authorization of sotrovimab for?
01
Patients diagnosed with mild to moderate COVID-19 who are at high risk for progressing to severe disease.
02
Individuals with underlying health conditions that increase the risk of severe illness from COVID-19.
03
Patients who have recently been exposed to the virus and show early signs of infection.
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What is authorization of sotrovimab for?
Authorization of sotrovimab is for the treatment of COVID-19 in certain high-risk patients.
Who is required to file authorization of sotrovimab for?
Healthcare providers administering sotrovimab are required to file for its authorization.
How to fill out authorization of sotrovimab for?
The authorization form should be filled out with patient details, medical history, and the reason for treatment.
What is the purpose of authorization of sotrovimab for?
The purpose is to ensure that patients receive the appropriate treatment under guidelines and to track usage.
What information must be reported on authorization of sotrovimab for?
Information such as patient demographics, clinical information, and previous treatment history must be reported.
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