You must download our forms and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology or need an interpreter.
Download and complete either the Word or PDF version of the:
- PBS/RPBS Safety Net prescription record form and application for a Safety Net card
- PBS/RPBS Safety Net prescription record form and application for a Safety Net card.
PBS is the Pharmaceutical Benefits Scheme.
RPBS is the Repatriation Pharmaceutical Benefits Scheme.
Page 1 of this form must be typed.
Each time you have a PBS/RPBS medicine supplied, hand both pages 1 and 2 of this form to the pharmacist.