Download and complete the Aboriginal Health Services (AHS) pharmaceutical supplies request and claim form.
Make sure you fill out all sections of the form. We’ll return incomplete or poor quality forms without payment.
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.