Note: Fields marked by * are compulsory
Click to download Adverse Event Reporting Form for detailed reporting.
After submitting the form online, you will receive an acknowledgement on your email address. You will be personally contacted only if any additional information is needed. If you require any help in filling the form, you can call our executive for online support
All the information and personal data you share with us will be protected and kept confidential. The information you provide may be shared with health authorities.
Reporting here does not constitute an admission that the company product caused or contributed to the reaction.