Acromegaly Initial PBS Authority application form (PB181)

Use this form for a patient aged 18 years or older, who has acromegaly.

Use this form if the patient is either starting initial Pharmaceutical Benefits Scheme (PBS) subsidised treatment with pasireotide or has been on treatment with pasireotide prior to 1 September 2016.

This form can be uploaded through HPOS. Read more about form upload in HPOS.
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

Page last updated: 5 December 2016

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