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. 

 

 

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