Adrenaline Device PBS Authority Form

This form can be used to request an authority from a clinical immunology/allergy specialist for an initial PBS Authority prescription of EpiPen® or EpiPen Jr® or Anapen® 500 adrenaline (epinephrine) injector devices. The form has been updated in July 2024 to include Anapen® 500, and to make it easier to find on the ASCIA website.

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 authority112.5 KB