Department of Health

Evusheld™ prescribing resources for GPs and specialists

Tixagevimab and cilgavimab (Evusheld™) is a pre-exposure prophylactic medication available to prevent COVID-19. Evusheld™ is now available in selected community and hospital pharmacies for prescribing by GPs and Non-GP specialists and will be dispensed free of charge to patients. Evusheld™ is available until 31 December 2022, for both first and second doses.

Prescriber Guide

The prescriber guide was designed to step clinicians through the process of assessing eligibility for Evusheld™, accessing, administering and other considerations. It includes links to all key forms and documents which may be required when considering Evusheld™ for a patient.

GP and non-GP specialists Evusheld™ prescriber guide:

Request to Access Form

This form must be completed and provided to the patient with the prescription in order for them to be dispensed Evusheld™ from participating community and hospital pharmacies. 

Evusheld™ can be administered by nursing staff at Supercare Pharmacies, or patients can return to the doctor’s clinic for administration. Supercare nursing staff work 6-10pm 7 days a week. This form can also be used to enable patients to access this service. Hospital pharmacies are only offering a dispensing service not administration.

Request to access form

Participating pharmacies

Evusheld™will be available at the following community and hospital pharmacies across metro and regional Victoria. Patient will require both the request to access form and a prescription to have Evusheld™ dispensed. Supercare nursing services are available at the community pharmacies only, not hospital pharmacies.

 

Metropolitan Melbourne

Suburb Pharmacy Contact details Nurse available for Evusheld™ injection
Ascot Vale Ascot Vale Pharmacy

67-69 Union Road, 3032

(03) 9370 4146

Yes
Balwyn Balwyn Day and Night Pharmacy

310-314 Whitehorse Road, 3103

(03) 9836 3245

Yes
Coburg Coburg Pharmacy 4 Less

1 Louisa Street, 3058

(03) 9386 6655

Yes
Craigieburn Chemist Discount Centre

2A/340 Craigieburn Road, 3064

(03) 9308 4981

Yes
Cranbourne North Cranbourne North Chemist Warehouse

180S William Thwaites Boulevard, 3977

(03) 8391 9509

Yes
Hoppers Crossing Hoppers Crossing Chemist Warehouse

Shop 24-25, 428 Old Geelong Rd, 3029

(03) 9931 0040

Yes
Keilor East Keilor East Chemist Warehouse, 3033

Lot 3 Milleara Road, 3033

(03) 9325 4660

Yes
Keysborough Parkmore Pharmacy 4 Less

Shop J01, 317 Cheltenham, 3131

(03) 9798 1936

Yes
Melbourne HealthSmart Pharmacy Victorian Comprehensive Cancer Centre

311 Grattan Street, 3000

(03) 9045 9777

Yes
Melton Melton Chemist Warehouse

Unit 4 Melton Gateway, 66-84 High Street 3337

(03) 9746 8733

Yes
Reservoir Reservoir Pharmacy 4 Less

Summerhill Shopping Centre, 13/850 Plenty Road, 3073

(03) 9957 8786

Yes
Ringwood Ringwood Chemist Warehouse

131-133 Maroondah Highway, 3134

(03) 9870 5022

Yes
Wantirna South Pharmacy@Knox

Shop 2081 Westfield Knox, 425 Burwood Highway 3152

(03) 9800 5199

Yes
Yarraville Carnovale Pharmacy

149 Somerville Road, Yarraville 3013

(03) 9314 7557

Yes

Regional Victoria

Suburb Pharmacy Contact details Nurse available for Evusheld™ injection
Albury  Albury Wodonga Health

201 Borella Road, 2640

(02) 6058 4665

No
Ararat  Ararat Base Hospital

Lot 5B Girdlestone Street, 3377

(03) 5352 9340

No
Bairnsdale  Bairnsdale Regional Health Service

122 Day Street, 3875

(03) 5150 3485

No
Ballarat  UFS Dispensaries

717 Sturt Street, 3350

(03) 5331 9811

Yes
Bendigo  Bendigo UFS Pharmacy

Corner View and Barnard Streets, 3530

(03) 5443 4610

Yes
Curlewis Curlewis Pharmacy 4 Less

10-11/90 Centennial Boulevard, 3222

(03) 5251 6781

Yes
Echuca Echuca Regional Hospital

226 Service Street, 3564

(03) 5485 5987

No
Hamilton Hamilton Base Hospital

20 Foster Street, 3300

(03) 5551 8398

No
Horsham Wimmera Healthcare Group

83 Baillie Street, 3400

(03) 5381 9247

No
Kyneton Kyneton Base Hospital

7-25 Caroline Chisholm Drive, 3444

(03) 5422 9906

No
Mildura Mildura Chemist Warehouse

114A-118 Langtree Avenue, 3500

(03) 5023 2383

Yes
Portland Portland District Health

141-151 Bentinck Street, 3305

(03) 5521 0329

No
Sale Central Gippsland Health

155 Guthridge Parade, 3850

(03) 5143 8610

No
Shepparton Shepparton Chemist Warehouse

425 Wyndham Street, 3630

(03) 5821 6000

Yes
Swan Hill Swan Hill District Health

48 Splatt Street, 3585

(03) 5033 9296

No
Traralgon Traralgon Chemist Warehouse

92 Franklin Street, 3844

(03) 5174 2003

Yes
Warragul West Gippsland Healthcare

41 Landsborough Street, 3820

(03) 5623 0639

No
Warnambool South West Healthcare

25 Ryot Street, 3280

(03) 5563 4170

No
Wonthaggi Bass Coast Health

235 Graham Street, 3995

(03) 5671 3227

No

 

Reviewed 22 December 2022

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