Authority for Authorised Person(s) to sign claim forms on behalf of a hospital authority form (PB142)

Use this form to authorise a person(s) to sign forms on behalf of a hospital authority seeking approval under section 94 or 100 of the National Health Act 1953 to supply pharmaceutical benefits and/or highly specialised drugs, authorise a pharmacist(s) to sign pharmaceutical benefit claim forms and endorse pharmaceutical benefit prescriptions on behalf of a hospital authority, request removal of previously authorised pharmacist(s).


Page last updated: 13 July 2016

This information was printed Sunday 25 September 2016 from It may not include all of the relevant information on this topic. Please consider any relevant site notices at when using this material.