In case of complaints relating to product quality we kindly ask you to fill out the form below or call us.

All information you provide will be treated as strictly confidential.

Product information

Product name *
Dosage form and strength*
Manufacturer*
Batch number*
Expiry date
Does product appearance correspond to information in the pack insert?*
Description of product defect*

Source of information

Contact person*
E-mail*
Telephone*
Address
What is the source of the product (pharmacy, distributor, doctor, other)
Your comments
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