Subcutaneous Immune Globulin

May 13, 2019 Update: The working group recommendations regarding the Cuvitru brand shortage are available here.

Subcutaneous immune globulin (SCIG) is a blood product licensed in Canada for the treatment of patients with primary immunodeficiency disease. Unlike IVIG, which is infused in a hospital, SCIG can be infused at home by a patient who has been trained.

This section provides templates for health authorities to develop and customize their own SCIG program. 

 

 Document Date: Dec 2011

SCIG Resource Kit

(for downloading and customization where appropriate) 

 SCIG Resource Kit Cover Sheet

  

 Provincial Guidelines for SCIG Home Infusion Programs

  
 Training Materials  

Teaching Plan

  

Patient Post-Training Quiz

  

Patient Skills Assessment

  

Patient Evaluation of Training

  

Pre-Training Letter to GP

  

Post-Training Letter to GP

  
Patient Handouts
  

Patient Brochure

  

Patient Handbook

  

Quick Reference Guide: How to draw SCIG into a syringe

  

Infusion Log

  
Form and Letter Templates
  

Patient Referral Form

  

Patient Consent and Participation Agreement 

  

Patient Intake Form 

  

SCIG Patient Enrolment Form - Vivaglobin 

  

SCIG Patient Enrolment Form - Gamunex 

  

SCIG Patient Enrolment Form - Hizentra

  

SCIG Product Order / Pick-up Form - Vivaglobin 

  

SCIG Product Order / Pick-up Form - Gamunex 

  

SCIG Product Order / Pick-up Form - Hizentra

  

Travel Letter - Vivaglobin

  

Travel Letter - Gamunex

  

Travel Letter - Hizentra 

  

TMS IVIG Request Process