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PBS public hospitals with a pharmacy supplying all PBS medicines
What you can order
You can order the following stationery through Health Professional Online Services (HPOS).
| Name | Description |
|---|---|
| PBS Safety Net entitlement card | An aqua card for customers who reach the PBS Safety Net entitlement 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 and RPBS repeat authorisation | A yellow, A5 form to attach to prescription to show the number of repeats and times dispensed. |
| PBS Safety Net reply paid envelope | Use this envelope to including claims for issuing PBS Safety Net cards only. Don’t send prescription claims in this envelope. |
| Hospital prescription form - computer generated | A blue, A4 portrait prescription. Hospital details are printed on the front of this prescription form. |
| Hospital prescription form pad - personalised | An A4, portrait pad for up to 10 standard or authority required items per prescription. Hospital details are pre-printed on this form. |
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. Use the PBS/RPBS Safety Net prescription record form and application for a Safety Net card form (PB240) |
|
PBS Safety Net claim for payment |
Use this form to claim a payment for issuing a PBS Safety Net card. You can make up to 12 claims per form. |
|
Manual payment reconciliation |
Use this form to claim for PBS items or highly specialised drugs. You don’t need this form if you claim online. Use the Approved supplier manual payment reconciliation form (PB242). |
Non-PBS public hospitals with a pharmacy supplying highly specialised drugs and trastuzumab only
What you can order
You can order the following stationery through HPOS.
| Name | Description |
|---|---|
| PBS and RPBS repeat authorisation | A yellow, A5 form to attach to a prescription to show the number of repeats and times dispensed. |
| Non-PBS reform public hospitals prescribing HSDs and trastuzumab only authority prescription form | A blue, handwritten, non-PBS reform public hospital pad to prescribe only one authority required item per prescription. Hospital details are pre-printed on this form. |
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. Use the PBS/RPBS Safety Net prescription record form and application for a Safety Net card from (PB240). |
|
Manual payment reconciliation form |
Use this form to claim for PBS items or highly specialised drugs. You don’t need this form if you claim online. Use the Approved supplier manual payment reconciliation form (PB242). |