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.

To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.

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: 10 December 2021