Acute myeloid leukaemia - initial grandfather maintenance PBS authority application form (PB254)
Use this form to apply for initial grandfather (maintenance treatment) PBS subsidised treatment with midostaurin for acute myeloid leukaemia.
Download and complete the Acute myeloid leukaemia - initial grandfather maintenance PBS authority application form.
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Page last updated: 20 February 2020
This information was printed 16 January 2021 from https://www.servicesaustralia.gov.au/organisations/health-professionals/forms/pb254. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.