Ankylosing spondylitis - continuing PBS authority application form (PB074)

Use this form to apply for continuing PBS subsidised treatment with biological agents for an adult patient with ankylosing spondylitis.

Biological agents refers to all of the following:

  • adalimumab
  • certolizumab
  • etanercept
  • golimumab
  • infliximab
  • secukinumab.
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: 13 November 2018