Free Eligibility Check

I understand that the long term side-effects of certain medications are unknown. I understand the medicines prescribed through the Therapeutic Goods Administration’s Special Access Scheme Category B (GA SAS-B) Program are unregistered medicines in Australia.

I understand that the quality, safety and efficacy of medicines prescribed from the Therapeutic Goods Administration’s Special Access Scheme Category B Program have not been formally assessed and are therefore experimental.

I understand that the prescribing doctor will report my treatment outcomes to the Australian Government, including the Therapeutic Goods Administration and the Department of Health.

I understand that the costs associated with any prescribed medicines through the TGA SAS-B Program is my sole responsibility.

I understand that I must not drive a motor vehicle or operate heavy machinery whilst under the treatment of experimental medicines through the GA SAS-B Program. I understand that driving a motor vehicle or operating heavy machinery whilst under the influence of unregistered and unapproved experimental medicines may cause adverse readings on Roadside Drug Testing apparatus, and may result in an infringement or criminal penalty notice being issued by relevant state policing authorities.

I understand the risks and complications that may be associated with unregistered medicine treatments. I agree to follow my prescribing doctors recommendation regarding dosage. I agree to report any adverse effects I may experience from taking the prescribed medicines, including but not limited to changes in levels of sedation, lethargy, fatigue, dry mouth, nausea, vomiting, diarrhea, drowsiness, dizziness, disorientation, agitation, balance problems, changes in memory, paranoid delusions or hallucinations.

I understand that there is the possibility of unknown risks and side effects.

I understand that any prescribed medicines through the GA SAS-B Program may
interact with my other medications, and doses may need to be adjusted accordingly. I understand and agree to keep a log of my doses and changes in symptoms due to the prescribing of unregistered medicines.

I understand and agree to attend regular follow-up consultations, either in-clinic or over the phone as directed by my prescribing doctor.

I understand and agree that I will not use any forms of illicit drugs, or any other Forms of medication that are not aware of, or prescribed by my prescribing doctor.

I understand and agree to notify my prescribing doctor of any changes to my other medications. I agree to share my clinical outcomes for medical research purposes.

Agree and Continue