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Fillable Form H119 (PB119) – Download and Complete Online

  1. Country Australia
  2. Language English
  3. Activity Pharmaceutical Benefits Scheme
  4. Department Health
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Fillable Form H119 (PB119) – Download and Complete Online

Form H119, also known as PB119, is the official application used by health professionals to request initial or switching PBS‑subsidised treatment with eculizumab or ravulizumab for patients with atypical haemolytic uraemic syndrome (aHUS). The form must be completed accurately before it can be uploaded to the Health Professionals Online Service (HPOS) or submitted through the online PBS Authorities system.

On this Formize landing page you can download the official fillable PDF, open it directly in our secure Formize PDF Filler app, and finish the whole process without installing any extra software. The filler works on any device – desktop, tablet or smartphone – and saves your entries automatically.

Below you will find everything you need to know about the form, step‑by‑step instructions for a smooth online experience, and answers to the most common questions.

FAQ
  • Is Form H119 the same as PB119?

    Yes. The official name is PB119, but many users refer to it as Form H119. Both refer to the same PBS authority application for aHUS treatment.

  • Do I need to download the PDF before using Formize?

    No. Simply click the **Fill out this form** button and the fillable PDF loads directly in the Formize app. Downloading is optional for offline backup.

  • Can I edit the form after I’ve saved it?

    Absolutely. The Formize app stores a temporary copy in your browser. Open the saved file again in the app to make changes before final submission.

  • What browsers are supported?

    Formize works with the latest versions of Chrome, Edge, Firefox, and Safari. Mobile browsers on iOS and Android are also fully supported.

  • Is my data secure?

    Yes. All data entered in the Formize PDF Filler is processed locally in your browser and never stored on our servers unless you choose to download the file.

  • Do I still need to upload the form to HPOS after filling it online?

    Yes. The completed PDF must be uploaded to the Health Professionals Online Service (HPOS) or submitted via the online PBS Authorities system as required by Services Australia.

  • What if I make a mistake on the form?

    You can correct any error by reopening the saved PDF in the Formize app, editing the fields, and re‑saving before you upload it.

  • Is there a fee to use Formize’s PDF filler?

    No. Formize provides the PDF filler for free for all public government forms.

HOW TO

How to fill out form h119 for free, online in 3 easy steps:

  1. 1
    Open the Fillable Form
    Click the **Fill out this form** button on this page. The Formize PDF Filler app will load instantly in your browser.
  2. 2
    Enter Your Information
    Complete each field – patient details, prescriber information, and treatment justification – using your keyboard or touch screen. All required fields are highlighted.
  3. 3
    Save and Submit
    When you’re done, click **Save & Download** to get a copy for your records, then use the HPOS portal to upload the completed PDF.
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