<< PHARMAC Services
Secure form submission
* You can also submit NPPA forms
via the Connected Health Network
Select which form you are submitting
How to attach your form and any supporting documents
Before you start:
- Check that the file size of each item you're going to submit is under 5 MB, and that all together they're under 20 MB. If they're bigger than that, this submission system won't accept them, so please print them and fax or post them to us:
PO Box 10-254
- If you want to keep a "receipt" saying we've received your application, read the instructions at the bottom of this page about allowing pop-ups.
Use the buttons below to attach the application form and any relevant documents of
support which may help in assessing this application. Supporting documents may include
clinic letters, lab results, hospital admission record's, management plan, and any
other information which may be relevant.
I'd like to save a message saying you got my form
If you want to save a message saying we've received your application you'll need to ensure that your browser allows popups from www.pharmac.govt.nz.
From the browser menu go to: Tools, Pop-up Blocker, Pop-up Blocker Settings, Add www.pharmac.govt.nz (the exact menu options will depend on your browser); or
Consult with your IT department.
When you press the "Submit" button the popup will be displayed.
In the popup go to the browser menu: File, Save Page As (the exact menu options will depend on your browser).
Save a copy of your application submission.