Growth Hormone Recommencement PBS authority application form (PB165)

Use this form for a patient who is recommencing PBS subsidised treatment and has previously received treatment under PBS section 100 Growth Hormone Program for the same condition.

This form must be completed by a medical practitioner in consultation with a nominated specialist or consultant physician in:

  • paediatric endocrinology, or
  • general paediatrics

PBS is the Pharmaceutical Benefits Scheme.

 
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