Use this form to apply for initial PBS-subsidised treatment with dasatinib in the 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 or need an interpreter.
You can upload this form in HPOS.
Download and complete the acute lymphoblastic leukaemia second line - dasatinib - initial authority application form.
This information was printed 31 January 2025 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.