Moderate to severe hidradenitis suppurativa - continuing PBS authority application form (PB219)
Use this form to apply for continuing PBS subsidised adalimumab treatment for a patient with moderate to severe hidradenitis suppurativa.
Download and complete the Moderate to severe hidradenitis suppurativa - continuing 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.
If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.
Page last updated: 3 February 2020