Application forms for Licences and Permits

Businesses that sell medicines and poisons by wholesale or retail require a licence under the Medicines and Poisons Act 2014.
Permits allow purchase of the substances listed on the permit from a licensed supplier.

Personal information forms

All applicants must complete a Personal Information Form: Identification, Fitness and Probity (Word 1.6MB). If the licence or permit is to be issued to a partnership, each business partner must complete the personal information form. If the licence or permit is to be issued to a body corporate, each corporate officer (directors, company secretary, chief executive officer or general manager and chief financial officer) must complete the personal information form.

A responsible person must be nominated for each premises on the licence or permit. Each nominated responsible person must complete a Personal Information Form: Identification, Fitness and Probity (Word 1.6MB).

Application forms

Ambulance Service

You need to fill in the Health Service Permit-Ambulance Service application form (Word 1.73MB) if you are a business and you want to purchase medicines because you are operating a service which provides ambulances and/or paramedical staff for emergency services, events, training or patient transfers.

First aid

You need to fill in the Health Service Permit - First Aid application form (Word 1.67MB) if you provide workplace first aid and want to purchase multiple packs of medicines, such as adrenaline autoinjectors and salbutamol inhalers, from a medicines wholesaler. If you only need one or two packs of these medicines, you can purchase them from a pharmacy without a permit. If you require prescription medicines for providing first aid services, you should engage the services of a medical practitioner or occupational health business and they will need to use the application form for a medical treatment permit.

Immunisation Service

You need to fill in the Health Service Permit - Immunisation Service application form (Word 1.67MB) if you are an immunisation provider and you want to purchase vaccines for use at specific sites or as part of a mobile service (such as a workplace).

Indent

You need to fill in the Indent Licence application form (Word 1.6MB) if you provide a sales brokerage service to supply medicines and poisons but do not take possession of medicines and poisons.

Industrial

You need to fill in the Industrial Poisons Permit application form (Word 923KB) if you are a business (including sole traders) and you want to purchase poisons for use in your business. This form is not for people who want to sell poisons in their business.

Medical/dental practice

You need to fill in the Health Service Permit - Medical/dental practice application form (Word 1.67MB) if you are a medical or dental practice, including private hospitals and day surgeries, and you want to purchase medicines for use at the practice. Please note: a permit is only required where you want to pool medicines for use by all practitioners.

Medical treatment

You need to fill in the Health Service Permit - Medical Treatment application form (Word 1.69MB) if you are a medical business and you want to purchase medicines for providing medical treatment services to third party sites (such as mining and resource industry sites).
New application (Word 1.69MB)
Amendment to existing permit (Word 929KB)

Other health service

The Other Health Service application form (Word 1.67MB) is for businesses who require scheduled medicines to provide health services, where no other application type is applicable. Cosmetic injection businesses should use this form.

Pharmaceutical Samples

You need to fill in the Pharmaceutical Samples Permit application form (Word 884KB) if you are pharmaceutical representative and you want to carry and store pharmaceutical samples.

Research/education

You need to fill in the Research/Education Permit application form (Word 899KB) if you are school, university, government department or research organisation and you want to purchase medicines or poisons for use in education or research.

Residential care

You need to fill in the Health Service Permit - Residential Care application form (Word 1.66MB) if you are a residential care facility and you want to purchase imprest medicines for the facility. Please note: a permit is not required for medicines that have been dispensed for individual residents.

Schedule 2 retail

You need to fill in the Schedule 2 Retail Licence application form (Word 1.6MB) if you are a country store or mine site shop and you want to sell Schedule 2 medicines in your shop. Licences will only be issued where the nearest pharmacy is at least 25 kms away.

Schedule 7 retail

You need to fill in the Schedule 7 Retail Licence application form (Word 1.7MB) if you are a business and you want to sell agricultural herbicides and pesticides in Schedule 7.

Stockfeed manufacture

You need to fill in the Stockfeed Manufacture Permit application form (Word 867KB) if you are a stockfeed manufacturer and you want purchase medicines (antibiotics) for adding to feed mixes.

Veterinary practice (including mobile vets)

You need to fill in the Veterinary Practice Permit application form (Word 911KB) if you are a veterinary surgeon operating a business and want to purchase medicines for use in your business.

Wholesale/manufacture

You need to fill in the Wholesale/Manufacture Licence application form (Word 1.7MB) if you are a business and want to manufacture and/or wholesale medicines and/or poisons.
Amendment forms
If there is a change to the ownership of the business a new application is required. If the licence or permit is to be changed in type between individual (on behalf of the business), partnership or corporate a new application is required.

Any changes involving persons responsible also require completion of the Personal Information Form: Identification, Fitness and Probity.

Changes may incur a fee.

Licence or Permit Amendment Form (Word 931KB)

You need to fill in this form to make changes to an existing licence or permit, such as changing the permit or licence holder or relocating the business.

Medical Treatment Permit Amendment Form (Word 929KB)

You need to fill in this form if you want to make changes to an existing medical treatment permit (for purchasing medicines as part of providing health services to mining and resource sites).
Renewal forms

If you have a current licence or permit, a renewal form will be posted to you approximately two months before it is due to expire.

To renew your licence or permit you must return the completed and signed form to the Medicines and Poisons Regulation Branch and pay the renewal fee. Fees can be paid by BPay or BPOINT. BPOINT payments (external site) can be made using a Mastercard or Visa credit card.

More information

Medicines and Poisons Regulation Branch
Mailing address: PO Box 8172, Perth Business Centre, WA 6849
Phone: 9222 6883
Email: poisons@health.wa.gov.au