Pharmacovigilance questionnaire to Marketing Authorisation Holders

 

The requested appendixes shall be named and numbered according to this web questionnaire. These appendixes shall be submitted either to an electronic mailbox, address finam.ev@nam.fi or in CD-ROM or USB-memory format to the National Agency for Medicines, address National Agency for Medicines / Safety and Drug Information, P.O.Box 55, FI-00301 Helsinki, Finland.

1. Marketing Authorisation Holder Contact Information
Name
 		Address
 		Website address
 
 

Contact person
Contact person name and company
 		Address
 
Telephone number
 		E-mail address