Make a statutory declaration if your pharmacy has missing prescriptions or claim-related paperwork.
Your pharmacy might have lost or damaged prescriptions or paperwork for claims due to circumstances outside of your reasonable control. If this happens, make a statutory declaration with a statement about the lost or missing paperwork.
Your declaration should include information about the nature of the loss, such as natural disaster, emergency or misplaced prescriptions. You must keep this for of 2 years for audit and verification purposes.
If you’re lodging a manual PBS claim, complete the statutory declaration form and send it to us with your other prescriptions and claim paperwork.
The following is an example you could use in your statutory declaration:
- I can’t provide the paper prescriptions to support this claim because of the effects of a fire.
- I haven’t and won’t make a claim against my insurance company for the lost claim. If I find the prescriptions or claim paperwork I’ll send it to the Department of Human Services with a note stating I won’t resubmit these prescriptions or claim paperwork for payment.
Send your signed and completed statutory declaration to:Teams Manager
Department of Human Services
GPO Box 9826 in your state
Read more about statutory declarations on the Attorney General's website.