Skills Checklist for Self-Administration of Subcutaneous - Hizentra 2026

1. Click 'Get Form' to open the Skills Checklist in our editor.
2. Begin by entering the patient's name clearly in the designated field at the top of the form.
3. In the 'Patient Skills Reviewed' section, ensure that each skill is checked off as it is reviewed with the patient. The RN should initial and date next to each skill.
4. For each skill listed, such as defining subcutaneous administration or describing aseptic technique, provide detailed notes or comments in the comments section if necessary.
5. In the 'Who Is Responsible for Administering SCIg?' section, select one option that applies to your situation by checking the appropriate box.
6. Complete any additional required information fields, including contact information for medication and medical issues.
7. Finally, ensure that both the patient trainee signature and date are filled out at the bottom of the form after completing all education sessions.

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