Stationery for public hospitals with a pharmacy

Stationery used by public hospitals with a pharmacy to prescribe and supply PBS/RPBS medicines and administer 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.

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.

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

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).

Page last updated: 22 August 2022