Existing Supplier Form (Non MC)

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Product Details

Product Name

TGA Trade name

As seen on the TGA Categories List

Product Images

Please upload at least one high quality image of product PRIMARY PACKAGING on white background. If your product is a flower, please upload a photo of the flower itself.

Drop files here or

Max. file size: 512 MB.

Product Brand

Product Schedule

TGA Dosage Form

GMP Status

GMP Certification

Max. file size: 512 MB.

Product Size (grams, ml, pieces)

Dosage Frequency (optional)

Product Description*

Product Specifications (PDF)

Max. file size: 512 MB.

Consumer Medicine Information (PDF)

Max. file size: 512 MB.

Certificate of Analysis (PDF)

Max. file size: 512 MB.

Country of Manufacture

Country where API is sourced

Active Ingredient mg Per Container

Active Ingredient mg/ml/piece and/or %

Current Batch Number

Current Expiry Date

Product Shelf Life/Retest Time

UPC Barcode Number

Quantity Per Outer Box/Shipper Carton

Product Temperature Storage Requirements

Expected Delivery of First Batch

Product Supply Lead Time (Approx.)

Pricing Details

Recommended Retail Price (RRP) to Patient

Wholesale Price (WS) to Pharmacy/Clinics

Price Per Total Active Ingredients (RRP/Total Active Ingredients Per Container)

BHC Service Fee %

BHC Service Fee $ (WS x BHC Service Fee %)

Price to BHC (WS - BHC Service Fee $)

Contact Person Submitting This Form

Contact Email

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Contact Email

Comments

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Existing Supplier Form (Non MC)

Product Details

Pricing Details

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