Download and complete the Acute lymphoblastic leukaemia - blinatumomab Initial (Induction) authority application form.
PBS is the Pharmaceutical Benefits Scheme.
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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