Chronic thromboembolic pulmonary hypertension Initial PBS authority application form (PB192)

Use this form for a patient starting initial treatment with riociguat for chronic thromboembolic pulmonary hypertension (CTEPH).

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: 23 January 2017

This information was printed Friday 24 March 2017 from humanservices.gov.au/health-professionals/forms/pb192 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.