Customer Request Form

PBS Information: Emergency Drug (Doctor’s Bag) Supply only.

PLEASE REVIEW PRODUCT INFORMATION BEFORE PRESCRIBING
Further information is available from 1800 PENTHROX (1800 736 847) or
[email protected]

Date of Preparation: April 2016

Address: 4 Caribbean Drive, Scoresby,
Victoria, 3179
Australia

Phone: +61 3 9547 1888

Email: [email protected]

ABN: 14 106 340 667

Website: www.medicaldev.com