Secukinumab for psoriatic arthritis Initial PBS grandfather authority application form (PB184)

Use this form for an adult patient starting initial (grandfather) PBS subsidised treatment with secukinumab only.

This form must be completed by a rheumatologist or clinical immunologist with expertise in the management of psoriatic arthritis.

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