Juvenile idiopathic arthritis for adult patients with onset prior to age 18 - continuing PBS authority application form (PB063)

Use this form for an adult patient with a documented history of juvenille idiopathic arthritis with the onset prior to age 18 continuing PBS subsidised treatment with bDMARD.

You should also use this form if the patient is changing to an alternate PBS subsidised treatment, recommencing treatment with the most recent PBS subsidised bDMARD or demonstrating a response to the current PBS subsidised treatment.

A rheumatologist or clinical immunologist with expertise in the management of rheumatoid arthritis must complete this form.

PBS is the Pharmaceutical Benefits Scheme.

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

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 13 March 2019

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