Systemic juvenile idiopathic arthritis continuing, retrial or recommencement or demonstration of response PBS authority application form (PB118)

Use this form to apply for continuing, retrialling or recommencing PBS subsidised tocilizumab treatment for systemic juvenile idiopathic arthritis.

Download and complete the Systemic juvenile idiopathic arthritis continuing, retrial or recommencement, or demonstration of response PBS 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.

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: 8 September 2020