Pharmacy: erectile dysfunction questionnaire

Summary:

For medical practitioners – complete this form to provide us with information on your patient’s erectile issues. We will then be able to determine if we can pay for your client’s erectile dysfunction medication.

Coronavirus update

The TAC is unable to send or receive hard copy documents at this time. Please email forms or other documents to info@tac.vic.gov.au and include the client's claim number in the subject line.