Patient consent forms

For s100 prescriptions, patients need to complete and sign a consent form with their prescriber/doctor.

s100 Highly Specialised Drugs

  • By signing the form, the patient agrees to have their co-payment contribution paid by the NSW Government over a 12 month period from the date included on the  12 Month Patient Consent Form
  • Examples of prescribing software compatible forms have been developed for Medical Director and Best Practice. These forms can be adapted to other prescribing software by your practice where appropriate.
  • The signed form must be presented each time a prescription is filled (including repeats) for the s100 co-payments to be made
  • Patients need to ensure that as they near the expiry of 12 months a new consent form is completed with their prescriber/ doctor.​

s100 injectable and infusible chemotherapy medicines

  • Patients sign a consent form when their prescription is filled through a pharmacy used by NSW public hospital oncology services
  • This form includes consent for the NSW Government to make the s100 co-payments on the patients' behalf.


More information

NSW s100 co-payment enquires can be emailed to:​

Current as at: Tuesday 18 December 2018
Contact page owner: Strategic Reform and Planning