Online claiming for Pharmaceutical Benefits Scheme - application and terms and conditions form (PB010)

• Online claiming for Pharmaceutical Benefits Scheme - application and terms and conditions form

You must complete a separate form and agree to the terms and conditions for each location you require online claiming in. 

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.