ADVERSE DRUG REACTION REPORTING FORM

Fill in a form for the health care professional

ADVERSE REACTION REPORTING FORM

Fill in a form for non- healthcare professional

If you suspect that you have experienced any adverse events from the use of any Accord or Actavis products, please contact us either through the form below or via [email protected] or telephone 0044 1271 385 257 so that we can assist you.

* Required information

ACCORD HEALTHCARE LTD
Sage House
319 Pinner Road
North Harrow
Middlesex
HA1 4HF

Tel: +44 208 8631427

Please be advised that the personal data collected in the report will be processed by Accord Healthcare Ltd. (Sage House, 319 Pinner Road, North Harrow. Middlesex, HA1. 4AF, United Kingdom) and used exclusively for the purposes related to the obligation to monitor the safety of medicines. Every person has the right to access and correct their data. Under the Pharmaceutical Law Act, art. 36, September 6th 2001, providing data indicated above by symbol * is mandatory . Providing other data is voluntary.