Adrenaline Device PBS Authority Form

Request for initial EpiPen® or EpiPen Jr® or Anapen® 500 to be provided on PBS Authority prescription by clinical immunology/allergy specialist - this form has been updated in July 2024 to include Anapen® 500.

When completing the form please refer to ASCIA Guidelines - Adrenaline (Epinephrine) Injector Prescription - www.allergy.org.au/hp/anaphylaxis/adrenaline-injector-prescription

ASCIA PBS adrenaline device authority100.97 KB