Sapropterin for BH4 deficiency Initial and continuing PBS authority application 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's details, including their Medicare card number and personal information such as name and date of birth. Ensure all entries are in BLOCK LETTERS.
3. Indicate whether this application is for initial treatment or continuing treatment by marking the appropriate box.
4. Fill in the patient's weight and required dose, ensuring accuracy as this information is critical for eligibility.
5. Complete the prescriber’s details section, including your prescriber number and contact information. Make sure to sign and date the declaration at the end of the form.
6. Attach all relevant pathology reports along with a completed authority prescription form before submitting your application.

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