Ankylosing spondylitis Initial PBS authority application form (PB073)

Use this form for an adult patient starting initial Pharmaceutical Benefits Scheme (PBS) subsidised treatment with a Tumour Necrosis Factor alpha (TNF╬▒) antagonist.

This form must be completed by a rheumatologist with expertise in the management of ankylosing spondylitis. 

 
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: 27 August 2017