Notice of intention to stop dealing (MPMR-43)

Section 43 of the Medicines and Poisons (Medicines) Regulation 2021 (MPMR) requires the holder of a substance authority to give notice to the chief executive of Queensland Health (or delegate) if they propose to stop carrying out a dealing with a medicine under their authority — this form must be used for this purpose.

The following information must be given by the substance authority holder under section 43(2) of the MPMR:

the day the dealing is proposed to stop;
the amount of medicine that is likely to be unused on the day mentioned in paragraph (a), if any;
how the substance authority holder proposes to deal with any unused medicine.

Collection notice:

The Department of Health is collecting your information in accordance with Section 43 of the Medicines and Poisons (Medicines) Regulation 2021 in order to meet reporting requirements for a substance authority holder. Personal information collected by the Department of Health is handled in accordance with the Information Privacy Act 2009. The personal information provided by you may be disclosed to a Hospital and Health Service, Public Health Unit for the purpose of carrying out compliance activity. Your personal information will not be disclosed to other third parties without consent, unless the disclosure is authorised or required by or under law.

For any questions regarding this collection notice, please contact Medicines Approvals and Regulation Unit (MARU) via email: MARU@health.qld.gov.au. For information about how the Department of Health protects your personal information, how to access or correct your own personal information, or how to make a complaint about a breach of the privacy principles and learn how we deal with such a complaint, please refer to: The Department of Health’s Privacy Policy.

Contact information

This notice is managed by the Medicines Approvals and Regulation Unit (MARU). Should you require assistance in completing this form, please email: MARU@health.qld.gov.au.

Required fields are marked with an asterisk (*).

1. Details of person making the notification

Title

Given name *

Surname *

Position *

Work phone *

Work email *

2. Details of substance authority holder making the notification

Entity name *

Substance Authority Reference *

Expiry date *

Day Month Year

Type of substance authority held

3. Details of intention to stop dealing

Date the dealing with regulated substances is proposed to stop *

Day Month Year

Reason for stopping dealing with regulated substances *

Other reason

Do you expect that you will have any unused medicines at the time of stopping dealing? *

Details of substances expected to be unused at the time of stopping dealing*

Generic name of substance	Quantity	Measure	Form	Strength

Proposal for dealing with unused regulated substances*

Does your substance authority allow you to undertake this proposed action?*

Further details of proposal for dealing with unused substances *

Please provide details of why you do not expect to have any unused medicines at the time of stopping dealing *

4. Additional information and attachments

Additional information

Upload additional supporting documents

Certification *

In giving this notice, I affirm that the information I have supplied is, to the best of my knowledge, complete, true, and accurate.

MPMR-43, Version 1

Last updated: 1 July 2025