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.
Download and complete the Request for Pharmaceutical Benefits Scheme claims information form.
This form should only be used to request PBS claims information from more than 2 years ago.
This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.
If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.
Page last updated: 12 July 2021
This information was printed 10 September 2021 from https://www.servicesaustralia.gov.au/individuals/forms/ms040. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.