Stationery for private hospitals with a pharmacy

Stationery that Section 94 private hospitals with a pharmacy use to prescribe PBS/RPBS medicines and administer the PBS Safety Net.

We have multiple system updates and changes to some of our content and services

Place your PBS stationery order now to get it before Christmas

PBS stationery orders won’t be processed between 23 December 2022 and 2 January 2023. To ensure you have enough supplies, place your orders by 30 November 2022. Although we’ll process orders after this date, your stationery may not arrive until January. Usual processing resumes January 2023.

PBS stationery orders

From 1 October 2022, the only way for pharmacies and hospitals to order PBS stationery is through HPOS. Find out more about ordering stationery through HPOS.

What you can order

You can order the following stationery through Health Professional Online Services (HPOS).

Name Description
PBS and RPBS repeat authorisation form A yellow, A5 form to attach to prescriptions to show number of repeats and times dispensed.
PBS Safety Net entitlement card An aqua card for customers who reach the PBS Safety Net general threshold. You must account for each card issued to your pharmacy.
PBS Safety Net concession card A blue card for customers who reach the PBS Safety Net concessional threshold. You must account for each card issued to your pharmacy.
PBS Safety Net reply paid envelope Use this envelope to include claims for issuing PBS Safety Net cards only. Don’t send prescription claims in this envelope.

What you can download and use

Name Description
PBS Safety Net prescription record form and application for a Safety Net card

For customers to keep a record of their PBS medicines and apply for a Safety Net card.

PBS/RPBS Safety Net stationery record form and application for a Safety Net card form (PB240).

PBS Safety Net claim for payment form

Use this form to claim a payment for issuing a PBS Safety Net card. You can make up to 12 claims per form.

Use the PBS Safety Net claim for payment form (PB241).

Manual payment reconciliation

Use this form to claim a payment for supplying PBS items or highly specialised drugs. You don’t need to use this form if you claim online.

Use the Approved supplier manual payment reconciliation form (PB242).

Page last updated: 1 October 2022