To find an Infusion Center Medication Orders form, click the link below to open the PDF, click 'Ctrl F' to search by medication name or keyword, note the form page number and print the desired form by page number. 

Infusion Center Medication Order Forms

COVID-19 Infusion (Monoclonal Antibody) Clinic Documents

Referrals are being accepted from local providers to make eligible referrals to our COVID-19 Infusion Clinic where we are giving Regeneron infusion treatments. Important notes: 

  • This is ONLY for providers in Lewis and Clark, Jefferson, Powell, Broadwater and Meagher Counties. 
  • Please note that we are NOT offering this therapy for the post-exposure prophylaxis indication. It is being reserved for eligible COVID positive patients in the outpatient setting. Patients must fall within infusion guidelines outlined in the Infusion Orders document below. 
  • Providers must to make a determination using their clinical judgement and published guidelines on whether the patient may benefit from this scarce resource, and then review the risks and benefits outlined in the Emergency Use Authorization (EUA) with the patient and complete a consent form. Informed consent is NOT happening at time of administration, and a signed informed consent is a required to be included when submitting a signed order
  • There are limited number of infusion appointments available

Once the documents are ready, please fax a copy of the completed Infusion Order and signed Consent Form to 406-495-6853. If you are an independent provider not employed by St. Peter's, please write the preferred phone number for each patient on the Consent Form before submission. Once all completed documents are submitted, a St. Peter's staff member will contact the patient directly to schedule their appointment. Patients will be instructed to present at their set appointment time to St. Peter’s Health Emergency Department located at 2475 Broadway in Helena.

Documents

Questions? Call the St. Peter's Health Infusion Center at 406-495-6852.