Severe chronic spontaneous urticaria - omalizumab initial PBS authority application form (PB223)
Use this form to apply for initial PBS subsidised omalizumab treatment for a patient with severe chronic spontaneous urticaria.
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