Request for Pharmaceutical benefits Scheme claims information form (MS040)

Use this form to request Pharmaceutical Benefits Scheme (PBS) claims information for individuals and families from more than 2 years ago.

This form should only be used to request PBS claims information from more than 2 years ago.

Page last updated: 21 July 2016

This information was printed Sunday 2 October 2016 from humanservices.gov.au/customer/forms/ms040 It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.