Commonwealth Numbered Regulations

1981 No. 218 NATIONAL HEALTH (PHARMACEUTICAL BENEFITS) REGULATIONS (AMENDMENT) - REG 6

6. Schedule 6 to the National Health (Pharmaceutical Benefits) Regulations is
repealed and the following Schedule substituted:
SCHEDULE 6
FORMS
FORM A
Regulation 8
COMMONWEALTH OF AUSTRALIA
National Health Act 1953
APPLICATION FOR APPROVAL AS A PHARMACEUTICAL CHEMIST
(by a Registered Pharmaceutical Chemist)

*I of We trading as hereby apply for approval as a pharmaceutical chemist
under the National Health Act 1953 in respect of premises situated at .
*I                      *I am a pharmaceutical

chemist
hereby declare
     that                                          registered as such under
the
laws of the
We                      we are pharmaceutical

chemists

*State
 Territory of          .

*I                    *I am

further declare
     that                           willing to supply on demand, at or from
the
premises specified above
We                    we are
pharmaceutical benefits in accordance with Part VII of the
National Health Act  1953 and the Regulations made under that Act.
Dated this         day of         19  .

(Signature of applicant)

* Strike out whichever is inapplicable.
--------
FORM B
Regulation 8
COMMONWEALTH OF AUSTRALIA
National Health Act 1953
APPLICATION FOR APPROVAL AS A PHARMACEUTICAL CHEMIST
(by the Legal Personal Representative of a deceased Pharmacist)

*I of We

*executor
being the             of the estate of

administrator
a deceased pharmaceutical chemist, trading as                   hereby apply
for approval, as a pharmaceutical chemist under the National Health Act 1953
in respect of premises situated at                                         .


*I
   hereby declare that                 deceased, was at the time of his death
on We
19 registered as a pharmaceutical chemist under the laws of the

*State
Territory of      and was carrying on the business of a pharmaceutical chemist
at the said premises.

*I We
further declare that a registered pharmacist will supply on demand, at or from
the premises specified above, pharmaceutical benefits in accordance with Part
VII of the National Health Act 1953 and the Regulations made under that Act.
Dated this
day of         19  .

(Signature of applicant)

* Strike out whichever is inapplicable.
--------
FORM C
Regulation 8
COMMONWEALTH OF AUSTRALIA
National Health Act 1953
APPLICATION FOR APPROVAL AS A PHARMACEUTICAL CHEMIST
(by a friendly society or a friendly society body) I, of the person authorized
to make this application by , which is a friendly society or body carrying on
business for the benefit of members of a friendly society or friendly
societies, hereby apply for approval of that friendly society or body as a
pharmaceutical
chemist under     of the National Health Act 1953 in respect of

premises situated

*Section 91 (2) Section 91 (3) at trading as The friendly society or body is
prepared to supply on demand, at or from its premises specified above,
pharmaceutical benefits in accordance with Part VII of the
National Health Act  1953 and the Regulations made under that Act. *I declare
that the friendly society or body was carrying on the business of a
pharmaceutical chemist on the twenty-third day of April, 1964.
Dated this         day of         19  .

(Signature of person authorized to make application)

*Strike out if inapplicable.
FORM D
Regulation 8
COMMONWEALTH OF AUSTRALIA APPLICATION FOR APPROVAL AS A HOSPITAL AUTHORITY FOR
THE PURPOSE OF
SUPPLYING PHARMACEUTICAL BENEFITS
National Health Act 1953 I,
of the person authorized to make this application by the   *governing
of the body
proprietor Hospital, which is a    hospital, hereby apply under the National
Health Act 
                    *private                      public 1953 for approval of
that hospital authority for the purpose of supplying pharmaceutical benefits
to patients receiving treatment in or at that hospital. The hospital authority
is prepared to supply pharmaceutical benefits in accordance with Part VII of
the National Health Act 1953 and the Regulations made under that Act. The
dispensing of drugs and medicinal preparations at the hospital is performed by
or under the direct supervision of a registered pharmaceutical chemist or a
registered medical practitioner.
Dated this         day of         19  .

(Signature of person authorized to make application)

*Strike out whichever is inapplicable
--------
FORM E
Regulation 8
COMMONWEALTH OF AUSTRALIA
National Health Act 1953
APPLICATION FOR APPROVAL TO SUPPLY PHARMACEUTICAL BENEFITS
(by a Registered Medical Practitioner) I, of hereby apply for approval to
supply pharmaceutical benefits under Section 92 of the National Health Act
1953, in the area of The nearest Pharmaceutical Chemist is located at I hereby
declare that I am a medical practitioner registered as such under the laws of
the State of
Medical Registration Certificate Number
Dated this         day of         19  .

(Signature of applicant)