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.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

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Page last updated: 27 August 2017