Crohn's disease paediatric continuing PBS authority application form (PB161)

Use this form to apply for continuing Pharmaceutical Benefits Scheme (PBS) subsidised treatment with a biological agent for paediatric refractory Crohn’s disease.

This form is for paediatric patients aged 6 to 17 years.

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