For Pharmacies and wholesalers

Step 1 :

Complete order form/Credit application form

( available below )

Step 2 :

Fax to 03 53090458 (or)

Email : sas@tridentpharmacy.com.au

Step 3 :

order confirmation/expected date of delivery  done within 24 hours

For Medical Practitioners

Step 1 :

Please Complete SAS C form + Prescription

( we will submit the form to TGA on your behalf)

Step 2 :

Fax to 03 53090458 & Post SAS C form + Prescription to

Trident Pharmacy

SHOP 1 , 2110 Glenelg Highway

Lake Bolac 3351 VIC

Step 3 :

Our Pharmacist will call the patient and acknowledge the receipt of the SAS C form and Prescription

Step 4 :

Our Pharmacist will dispense the medicine and post the medicine to the customer. Medication counseling will be provided via telehealth 

For Customers

Please talk to our pharmacist on 03 53090445 for details on how to access SAS C medications


Credit Application form (pdf)


special-access-scheme-category-c-form March 2018 (pdf)


Order form (pdf)