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IVIG/SCIG

Use of the MOHLTC IG Request Form

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

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

Ontario MOHLTC IG Request Form Non-Neurology-fillable

Version 5.0 January 2018

Ontario MOHLTC IG Request Form Neurology

Ontario MOHLTC IG Request Form Neurology

Version 3.0 January 2018

Ontario MOHLTC IG Request Form for Neurology – fillable

Ontario MOHLTC IG Request Form for Neurology – fillable

Version 3.0 January 2018

Ontario IG Utilization Management Guidelines

Ontario IG Utilization Management Guidelines

The information in this document is intended as a guideline for clinicians seeking clarification on the common and clinically appropriate uses of Immune Globulin in Ontario V4.0 January 31 2018

Ontario IG Utilization Management Strategy Update

Ontario IG Utilization Management Strategy Update

January 31, 2018

BMI/Dose Calculator

BMI/Dose Calculator

An ideal body weight calculator allowing for calculation of appropriately adjusted doses of IVIG for obese patients. Version 3, January 31, 2018

Ontario IVIG Infusion Guide and Adverse Reaction Chart

Ontario IVIG Infusion Guide and Adverse Reaction Chart

Fact Sheet for IVIG Outpatients

Fact Sheet for IVIG Outpatients

A brief fact sheet for outpatients that help them to understand the risks, benefits and possible side effects of receiving Intravenous Immune Globulin. Version 2.0 October 31, 2015.