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  • Create Date February 6, 2022
  • Last Updated October 2, 2023

Paxlovid Rx eFORM (COVID therapy)

This eFORM provides access to oral medication to treat high-risk COVID patients in the community.

V2_Feb6_2022 has the relevant web links for the references on the back page.  Thanks to Dr. H Chang.

V3_Jun26_2022 updated with the May2022 background.  Noted by attendee at OscarCON 2022.

V4_Jul8_2022 has pharmacy location fax bug fixed.

V5_Apr4_2023 has been updated to allow for contingency Rx of Paxlovid.  The patient must still meet all eligibility requirements and any drug interactions need to be reviewed.

Apologies to early adopters of  V5_Apr4_2023.  There were logic problems between the immediate and future Rx options.  Corrected in V5_Apr5_2023.

V6_Oct2_2023 - simplified for immediate Rx or contingency (pre-emtpive) Rx.

Attached Files and Latest Versions

FileAction
Paxlovid_Rx_V6_Oct3_2023.zipDownload
Paxlovid_Rx_V5_Apr5_2023.zipDownload
Paxlovid_Rx_V4_Jul8_2022.zipDownload
Paxlovid_Rx_V2_Feb6_2022.zipDownload