Request for prescriber bag supplies order book form (PB157)

Use this form to order the Prescriber bag supplies order book to get some PBS medicines to give to patients for emergency use if you are an eligible prescriber.

Download and complete either the Word or PDF version of the:

We will only accept typed prescription order forms. We will return handwritten, incomplete or poor quality forms to the prescriber.

PBS is the Pharmaceutical Benefits Scheme. 

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 contact us. We can help you access, complete and submit them.

Page last updated: 24 August 2020