Ordering IG in Ontario
Ontario IG Utilization Management Strategy
| Revised: 31 Jan 2018The IG Utilization Management Strategy applies to all hospitals where IG is dispensed by either a transfusion service or pharmacy. Physicians and practitioners who order IG must be made aware of and adhere to these strategies.
Use of the MOHLTC IG Request Form
This document provides information on use of the MOHLTC IG Request Forms and a description of the responsibilities of healthcare professionals involved in the ordering process
Ontario MOHLTC IG Request Form Non-Neurology
A standardized request form that references the 2018 Ontario IG Utilization Management Guidelines. Version 5.0 January 2018 Please note: This form is to be used for non-neurology indications ONLY
Ontario MOHLTC IG Request Form Non-Neurology-fillable
Version 5.0 January 2018
Ontario MOHLTC IG Request Form Neurology
Version 3.0 January 2018
Ontario MOHLTC IG Request Form for Neurology – fillable
Version 3.0 January 2018
SCIG Product Request Form
Version 4 March 2025
Updated to better reflect current ordering practices and include ramp up dosing section for HyQvia.