Asthma - adolescent and adult continuing PBS authority application form (PB076)
Use this form to apply for continuing PBS subsidised treatment with biological agents for uncontrolled severe asthma.
Download and complete the Asthma - adolescent and adult - continuing 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: 6 November 2020
This information was printed 5 January 2021 from https://www.servicesaustralia.gov.au/organisations/health-professionals/forms/pb076. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.