Asthma - adolescent and adult initial PBS authority application form (PB075)

Use this form to apply for initial PBS subsidised biological agent treatment for uncontrolled severe asthma.

Download and complete the Asthma - adolescent and adult - initial PBS authority application form.

This form is for patients aged 12 years or older.

PBS is the Pharmaceutical Benefits Scheme.

This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.

You can upload this form in HPOS.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please contact us. We can help you access, complete and submit them.

Page last updated: 20 April 2020