Details of Proposed PAS Proposed PAS type: Please indicate the type of proposed PAS: Simple PAS with amendment to for Simple Scheme Standard “PAS Submission” Complex scheme Proposed cost reduction mechanism (with all stated prices excluding VAT): The cost reduction mechanism will be For simple PAS only Pack NHS List Discount Strength Form PAS Price (£) Size Price (£) (%) The following supporting documents have been enclosed with the application: PAS Patient Registration Form PAS Claim Form Other supporting documents
Details of Proposed PAS Proposed PAS type: Please indicate the type of proposed PAS: Simple PAS with amendment to Standard “PAS Submission” for Simple Scheme Complex scheme Proposed cost reduction mechanism (with all stated prices excluding VAT): The cost reduction mechanism will be For simple PAS only Strength Form Pack Size NHS List Price (£) Discount (%) PAS Price (£) The following supporting documents have been enclosed with the application: PAS Patient Registration Form PAS Claim Form Other supporting documents
full-patient-access-scheme-pas-application-v50-final.docx