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Get Application For Authority To Prescribe - Nsw Health - Health Nsw Gov

STRICTLY CONFIDENTIAL PHARMACEUTICAL SERVICES NSW MINISTRY OF HEALTH APPLICATION FOR AUTHORITY TO PRESCRIBE 11/12 IN ACCORDANCE WITH SECTION 29 UNDER THE POISONS AND THERAPEUTIC GOODS ACT 1966 REFER TO INSTRUCTIONS ON THE REVERSE SIDE. Patient ID No PLEASE USE BLOCK LETTERS. START DATE Y / N OFFICE USE ONLY Specify the NAME of the patient s CURRENT prescriber PATIENT SURNAME TRANSFER Is the patient TRANSFERRING from GAOL GIVEN NAMES fir.

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