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

Use this form to register for Online Claiming for Pharmaceutical Benefits Scheme (PBS).

Download and complete the 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.

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

Page last updated: 3 March 2022