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. 

 

 

SCIG Resource Kit

SCIG Resource Kit Cover Sheet

Under Review 

Provincial Guidelines for SCIG Home Infusion Programs

Under Review 
 Training Materials  

Teaching Plan

 Under Review

Patient Post-Training Quiz

 

Patient Skills Assessment

 

Patient Evaluation of Training

 

Pre-Training Letter to GP

Under Review 

Post-Training Letter to GP

 Under Review
Patient Handouts
 

Patient Brochure

 Under Review

Patient Handbook

 

Quick Reference Guide: How to draw SCIG into a syringe

Under Review 

Infusion Log

 
Form and Letter Templates
 

Patient Referral Form

Under Review 

Patient Consent and Participation Agreement 

 

Patient Intake Form 

 

SCIG Patient Enrolment Form - Gamunex 

 

SCIG Patient Enrolment Form - Hizentra

 

SCIG Product Order / Pick-up Form - Gamunex 

 

SCIG Product Order / Pick-up Form - Hizentra

 

Travel Letter - Gamunex

 

Travel Letter - Hizentra