Alzheimer disease PBS Initial authority application form (PB121)

This form is to assist prescribers submitting a written application by post for a Pharmaceutical Benefits Scheme (PBS) Authority approval of a medication for the treatment of Alzheimer's disease. This form may be used for initial applications and for first continuing applications.

 

Page last updated: 5 February 2016

This information was printed Sunday 25 September 2016 from humanservices.gov.au/health-professionals/forms/pb121 It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.