Ulcerative colitis - paediatric change or recommencement or demonstration of response PBS authority application form (PB246)
Use this form to apply for changing or recommencing or demonstrating a response. This is for PBS subsidised biological agent treatment for a paediatric patient with ulcerative colitis.
This form is for patients aged 6 to 17.
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: 3 February 2020