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

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