Use this form to apply for initial PBS-subsidised dasatinib for second line treatment of acute lymphoblastic leukaemia.
You must download our forms and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology.
You can upload this form in HPOS.
Download and complete the acute lymphoblastic leukaemia - second line - dasatinib initial PBS authority application form.
This information was printed 26 December 2024 from https://www.servicesaustralia.gov.au/pb077. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/site-notices when using this material.