Multiple myeloma - newly diagnosed - lenalidomide Initial PBS authority application form (PB200)

Use this form to apply for initial PBS subsidised lenalidomide treatment for a patient with newly diagnosed multiple myeloma.

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: 12 May 2017

This information was printed Thursday 25 May 2017 from humanservices.gov.au/health-professionals/forms/pb200 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.