Australian Thalidomide Survivors Support Program Health Care Assistance Fund form (PB300)

Use this form if you’re a recognised Australian thalidomide survivor, registered with the Australian Thalidomide Support Program.

Download and complete the Health Care Assistance Fund form.

This fund helps cover the out of pocket health care costs directly associated with thalidomide-related injuries. This may include any of the following:

  • health products and consumables
  • out of pocket pharmaceuticals
  • out of pocket health services, including medical, surgical and allied health
  • health-related travel and transport costs.

You need to provide documents to support your information. The form will tell you what documents to provide.

If you use assistive technology, you may not be able to access our forms. For help or information on completing the form, call us on 1800 565 863 Monday to Friday, 8:30am to 5pm, Australian Eastern Standard Time.

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: 27 March 2021