APPENDIX 3 AUTHORISATION OF SUPPLY UNDER s19(5)/41HC THERAPEUTIC GOODS ACT 1989 CONSENT TO TREATMENT AND INDEMNITY FOR USE OF PRODUCTS DERIVED FROM BIOLOGICAL TISSUE INCLUDING HUMAN BLOOD OR PLASMA AUTHORISATION OF SUPPLY UNDER s19(5) OR SECTION 41HC THERAPEUTIC GOODS ACT 1989 Consent to Treatment and Indemnity for Use of Products Derived from Biological Tissue Including Human Blood or Plasma I, ……………………………………………………………………………………………... (name of patient or parent/guardian) understand that the Commonwealth can give no guarantee as to the quality, safety or efficacy of product), of…………………………………………………………………..………(name particularly as regards any prion or viral inactivation procedures used in its manufacture. Accordingly, the Commonwealth can accept no liability for its use. I understand that this product is not approved for use in Australia but that use of the product has been approved under the provisions of section 19(5) or section 41HC of the Therapeutic Goods Act 1989.
APPENDIX 3 AUTHORISATION OF SUPPLY UNDER s19(5)/41HC THERAPEUTIC GOODS ACT 1989 CONSENT TO TREATMENT AND INDEMNITY FOR USE OF PRODUCTS DERIVED FROM BIOLOGICAL TISSUE INCLUDING HUMAN BLOOD OR PLASMA AUTHORISATION OF SUPPLY UNDER s19(5) OR SECTION 41HC THERAPEUTIC GOODS ACT 1989 Consent to Treatment and Indemnity for Use of Products Derived from Biological Tissue Including Human Blood or Plasma I, ……………………………………………………………………………………………... (name of patient or parent/guardian) understand that the Commonwealth can give no guarantee as to the quality, safety or efficacy of…………………………………………………………………..………(name of product), particularly as regards any prion or viral inactivation procedures used in its manufacture. Accordingly, the Commonwealth can accept no liability for its use. I understand that this product is not approved for use in Australia but that use of the product has been approved under the provisions of section 19(5) or section 41HC of the Therapeutic Goods Act 1989.
access-authorised-prescriber-guidelines.docx