Secukinumab for psoriatic arthritis Initial PBS grandfather authority application form (PB184)

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

This form must be completed by a rheumatologist or clinical immunologist with expertise in the management of psoriatic arthritis.

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

This information was printed Tuesday 6 December 2016 from humanservices.gov.au/health-professionals/forms/pb184 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.