Severe chronic plaque psoriasis - initial authority application form (PB112)

Use this form to apply for initial PBS subsidised treatment with a biological agent for adult patients with severe chronic plaque psoriasis.

Biological agent refers to:

  • adalimumab
  • etanercept
  • guselkumab
  • infliximab
  • ixekizumab
  • risankizumab
  • secukinumab
  • tildrakizumab
  • ustekinumab

Download and complete the severe chronic plaque psoriasis - initial authority application form.

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.

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Page last updated: 1 January 2021