Diabetic macular oedema - initial PBS authority application form (PB155)

Use this form to apply for initial PBS subsidised treatment with ranibizumab, aflibercept or dexamethasone intravitreal implants for Diabetic Macular Oedema.

Download and complete the Diabetic macular oedema - initial PBS authority application form.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

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Page last updated: 31 January 2020