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.

To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.

You can upload this form in HPOS.

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Page last updated: 26 September 2022