Multiple myeloma, newly diagnosed - lenalidomide initial PBS authority application form (PB200)
Use this form to apply for initial PBS subsidised lenalidomide treatment for a patient with newly diagnosed multiple myeloma.
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.
If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.
Page last updated: 13 February 2019
This information was printed 18 July 2019 from https://www.humanservices.gov.au/organisations/health-professionals/forms/pb200. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.humanservices.gov.au/individuals/site-notices when using this material.