Form HCA13-771 Request for Synagis - Washington

Form HCA13-771 Request for Synagis - Washington

What Is Form HCA13-771?

This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form HCA13-771?A: Form HCA13-771 is a request form for Synagis in the state of Washington.

Q: What is Synagis?A: Synagis is a medication used to prevent severe respiratory syncytial virus (RSV) disease in high-risk infants and children.

Q: Who can use Form HCA13-771?A: Form HCA13-771 is for healthcare providers in Washington who are requesting Synagis for their patients.

Q: Do I need to submit Form HCA13-771 to request Synagis?A: Yes, healthcare providers in Washington need to submit Form HCA13-771 to request Synagis for their patients.

Q: Is there a deadline to submit Form HCA13-771?A: There is no specific deadline mentioned for submitting Form HCA13-771, but it is recommended to submit it in a timely manner to ensure timely access to Synagis.

Q: Are there any eligibility criteria to use Form HCA13-771?A: Yes, there are specific eligibility criteria to qualify for Synagis treatment, which are mentioned in the form.

Q: Can parents or caregivers use Form HCA13-771?A: No, Form HCA13-771 is specifically for healthcare providers to request Synagis on behalf of their patients.

Q: Are there any fees associated with Form HCA13-771?A: There is no mention of any fees associated with submitting Form HCA13-771.

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Form Details:

  • Released on August 1, 2016;
  • The latest edition provided by the Washington State Health Care Authority;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form HCA13-771 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.

Download Form HCA13-771 Request for Synagis - Washington

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