Use this form to order the Prescriber bag supplies order book to get some PBS medicines to give to patients for emergency use if you are an eligible prescriber.
We will only accept typed prescription order forms. We will return handwritten, incomplete or poor quality forms to the prescriber.
PBS is the Pharmaceutical Benefits Scheme.
This PDF is fillable. Download this form and complete it on your device. Handwritten, incomplete or poor quality forms will be returned.