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HEPATITIS C REFERRAL FORM 210 Rock Rd Glen Rock, NJ 07452 8553599679 TEL: 6105456040 FAX: 6105456030 Today's Date CURRENT PATIENT NEW PATIENT First Name Middle Name Last Name Patient Name DOB Emergency
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How to Fill Out Hepatitis C Viekira Pak:

01
Consult a healthcare professional: It is crucial to seek guidance from a healthcare professional who can provide the appropriate dosage instructions and monitor your progress throughout the treatment.
02
Understand the treatment duration: Hepatitis C Viekira Pak is typically taken for 12 to 24 weeks, depending on the specific genotype of the hepatitis C virus. You should be aware of the duration and adhere to the prescribed schedule.
03
Take the medication with food: Hepatitis C Viekira Pak should be taken with a meal to enhance absorption and reduce the risk of gastrointestinal side effects. It is important to take it as directed, at the same time every day.
04
Store the medication correctly: Ensure that the medication is stored at room temperature, away from moisture and heat. Follow the storage instructions provided by the manufacturer to maintain the drug's stability and effectiveness.
05
Understand potential side effects: Familiarize yourself with the possible side effects associated with Hepatitis C Viekira Pak, which may include fatigue, headache, itching, and nausea. If you experience any severe or persistent side effects, inform your healthcare provider immediately.
06
Comply with additional appointments: During the treatment, your healthcare professional may schedule regular check-ups and lab tests to monitor your response and adjust the treatment if necessary. Attend these appointments as requested to ensure optimal outcomes.
07
Avoid alcohol and certain medications: It is important to avoid consuming alcohol or taking medication that may interact with Hepatitis C Viekira Pak, as this can affect the effectiveness and safety of the treatment. Discuss potential interactions with your healthcare provider.
08
Complete the full course of treatment: To maximize the chances of achieving a sustained virological response, it is crucial to complete the full prescribed course of Hepatitis C Viekira Pak. Even if you start feeling better before completion, do not stop taking the medication without consulting your healthcare provider.

Who Needs Hepatitis C Viekira Pak:

01
Individuals diagnosed with hepatitis C: Hepatitis C Viekira Pak is specifically indicated for the treatment of chronic hepatitis C infection in adults. It targets specific genotypes of the virus and should be prescribed after confirmation of the hepatitis C diagnosis.
02
Patients with specific genotype: The decision to use Hepatitis C Viekira Pak is based on the genotype of the hepatitis C virus. Your healthcare provider will determine if you have the appropriate genotype for this medication through testing.
03
Patients without contraindications: Certain medical conditions may contraindicate the use of Hepatitis C Viekira Pak. It is essential to discuss your medical history and any other ongoing treatments or medications with your healthcare provider to ensure its safe and appropriate use.
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Hepatitis C Viekira Pak is a medication used to treat chronic hepatitis C virus infection.
Patients with hepatitis C virus infection who have been prescribed Viekira Pak are required to fill out the medication.
Hepatitis C Viekira Pak should be taken as directed by a healthcare provider. Patients should follow the instructions provided with the medication.
The purpose of Hepatitis C Viekira Pak is to help cure chronic hepatitis C virus infection.
Patients must report any side effects or concerns related to taking Viekira Pak to their healthcare provider.
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