Secukinumab for ankylosing spondylitis Initial PBS grandfather authority application form (PB183)

Use this form for an adult patient starting initial (grandfather) PBS subsidised treatment with secukinumab only.

This form must be completed by a rheumatologist.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

Page last updated: 14 October 2016

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