How to use our forms
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.
You can also use this form for initial PBS-subsidised second-line treatment with eltrombopag for patients with the same condition.
Please note: You don’t need to complete this form if you use the Online PBS Authorities system.
Download and complete the severe aplastic anaemia - eltrombopag - initial authority application form.