Ulcerative colitis adult - initial authority application form (PB127)

Use this form to apply for initial PBS-subsidised treatment with a biological medicine for adult patients with moderate to severe ulcerative colitis or etrasimod for patients with moderate to severe ulcerative colitis.

You must download our forms to fill them in. We have help available if you use assistive technology or if you need a translator or interpreter. Find out how to use our forms.

You can upload this form in HPOS.

Biological medicine refers to:

  • adalimumab
  • etrasimod
  • golimumab
  • infliximab
  • ozanimod
  • tofacitinib
  • upadacitinib
  • ustekinumab
  • vedolizumab.

Please note: You don’t need to complete this form if you use the Online PBS Authorities system.

Download and complete the ulcerative colitis adult - initial authority application form.

Page last updated: 1 August 2025.
QC 21221